74R9438 DLF-D
          By Maxey, Berlanga, Hirschi,                          H.B. No. 1048
             McDonald, Delisi, et al.
          Substitute the following for H.B. No. 1048:
          By Berlanga                                       C.S.H.B. No. 1048
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to the creation of the Texas Health Care Information
    1-3  Council; providing civil penalties.
    1-4        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-5        SECTION 1.  Subtitle E, Title 2, Health and Safety Code, is
    1-6  amended by adding Chapter 108 to read as follows:
    1-7          CHAPTER 108.  TEXAS HEALTH CARE INFORMATION COUNCIL
    1-8        Sec. 108.001.  CREATION OF COUNCIL.  The Texas Health Care
    1-9  Information Council shall administer this chapter and report to the
   1-10  governor, the legislature, and the public.
   1-11        Sec. 108.002.  DEFINITIONS.  In this chapter:
   1-12              (1)  "Board" means the Texas Board of Health.
   1-13              (2)  "Charge" or "rate" means the amount billed by a
   1-14  provider for specific procedures or services provided to a patient
   1-15  before any adjustment for contractual allowances.  The term does
   1-16  not include copayment charges to health maintenance organization
   1-17  enrollees by providers paid by capitation or salary in a health
   1-18  maintenance organization.
   1-19              (3)  "Council" means the Texas Health Care Information
   1-20  Council.
   1-21              (4)  "Data" means information collected under Section
   1-22  108.009 in the form initially received.
   1-23              (5)  "Department" means the Texas Department of Health.
   1-24              (6)  "Health care facility" means:
    2-1                    (A)  a hospital;
    2-2                    (B)  an ambulatory surgical center licensed under
    2-3  Chapter 243;
    2-4                    (C)  a chemical dependency treatment facility
    2-5  licensed under Chapter 464;
    2-6                    (D)  a renal dialysis facility;
    2-7                    (E)  a birthing center;
    2-8                    (F)  a rural health clinic; or
    2-9                    (G)  a federally qualified health center as
   2-10  defined by 42 U.S.C.  Section 1396d(l)(2)(B).
   2-11              (7)  "Health maintenance organization" means an
   2-12  organization as defined in Section 2, Texas Health Maintenance
   2-13  Organization Act (Article 20A.02, Vernon's Texas  Insurance Code).
   2-14              (8)  "Hospital" means a public, for-profit, or
   2-15  nonprofit institution licensed or owned by this state that is a
   2-16  general or special hospital, private mental hospital, chronic
   2-17  disease hospital, or other type of hospital.
   2-18              (9)  "Outcome data" means measures related to the
   2-19  provision of care, including:
   2-20                    (A)  patient demographic information;
   2-21                    (B)  patient length of stay;
   2-22                    (C)  mortality;
   2-23                    (D)  co-morbidity;
   2-24                    (E)  complications; and
   2-25                    (F)  charges.
   2-26              (10)  "Physician" means an individual licensed under
   2-27  the laws of this state to practice medicine under the Medical
    3-1  Practice Act (Article 4495b, Vernon's Texas Civil Statutes).
    3-2              (11)  "Provider" means a physician, health care
    3-3  facility, or health maintenance organization.
    3-4              (12)  "Provider quality" means the extent to which a
    3-5  provider renders care that, within the capabilities of modern
    3-6  medicine, obtains for patients medically acceptable health outcomes
    3-7  and prognoses, after severity adjustment.
    3-8              (13)  "Rural provider" means a provider located in:
    3-9                    (A)  a county with a population of not more than
   3-10  35,000;
   3-11                    (B)  those portions of extended cities that the
   3-12  United States Bureau of the Census has determined to be rural; or
   3-13                    (C)  an area that is not delineated as an
   3-14  urbanized area by the United States Bureau of the Census.
   3-15              (14)  "Severity adjustment" means a method to stratify
   3-16  patient groups by degrees of illness and mortality.
   3-17              (15)  "Uniform patient identifier" means a number
   3-18  assigned to an individual patient and composed of numeric, alpha,
   3-19  or alphanumeric characters.
   3-20              (16)  "Uniform physician identifier" means a number
   3-21  assigned to an individual physician and composed of numeric, alpha,
   3-22  or alphanumeric characters.
   3-23        Sec. 108.003.  COUNCIL COMPOSITION; EXPENSES.  (a)  The
   3-24  council is composed of three nonvoting ex officio state agency
   3-25  members and 15 members appointed by the governor in accordance with
   3-26  this section.
   3-27        (b)  The nonvoting ex officio members of the council are:
    4-1              (1)  the commissioner of public health;
    4-2              (2)  the commissioner of health and human services; and
    4-3              (3)  the commissioner of insurance.
    4-4        (c)  The governor shall appoint the following members of the
    4-5  council:
    4-6              (1)  three representatives of the business community,
    4-7  with at least one representing small businesses, who are purchasers
    4-8  of health care but who are not involved in the provision of health
    4-9  care or health insurance;
   4-10              (2)  two representatives from labor, one of whom is not
   4-11  directly involved with management of health care benefits;
   4-12              (3)  two representatives of consumers who are not
   4-13  professionally involved in the purchase, provision, administration,
   4-14  or review of health care or health care insurance;
   4-15              (4)  two representatives of hospitals;
   4-16              (5)  one representative of health maintenance
   4-17  organizations;
   4-18              (6)  three representatives of physicians who are
   4-19  involved in direct patient care; and
   4-20              (7)  two members who are not professionally involved in
   4-21  the purchase, provision, administration, or review of health care
   4-22  or health care insurance and who have expertise in:
   4-23                    (A)  health planning;
   4-24                    (B)  health economics;
   4-25                    (C)  provider quality assurance; or
   4-26                    (D)  statistics or health data management.
   4-27        (d)  The chairman is appointed by and serves at the pleasure
    5-1  of the governor.  Members annually shall elect a vice chairman.
    5-2        (e)  A majority of voting members constitutes a quorum for
    5-3  the transaction of any business.  An act by the majority of the
    5-4  voting members present at any meeting at which there is a quorum is
    5-5  considered to be an act of the council.
    5-6        (f)  The council may appoint subcommittees and may elect any
    5-7  officers subordinate to those provided for in Subsection (d).
    5-8        (g)  The council shall appoint technical advisory committees.
    5-9  The technical advisory committees shall work in coordination with
   5-10  each other and may consult with other professionals, as necessary.
   5-11  The technical advisory committees shall include:
   5-12              (1)  a technical advisory committee that includes,
   5-13  among other individuals, at least five practicing physicians
   5-14  licensed in this state to provide advice and recommendations to the
   5-15  council on:
   5-16                    (A)  the development and implementation of the
   5-17  methodology and the interpretation of provider quality data under
   5-18  Section 108.010; and
   5-19                    (B)  the development and dissemination of
   5-20  consumer education information and materials; and
   5-21              (2)  a technical advisory committee composed of at
   5-22  least five practicing physicians licensed in this state who have
   5-23  been actively engaged in organized peer review at a hospital in
   5-24  this state to provide advice, recommendations, and peer review
   5-25  expertise to the council on:
   5-26                    (A)  the use of peer review in the determination
   5-27  of quality inpatient care;
    6-1                    (B)  the development and interpretation of data
    6-2  elements necessary to the determination of quality inpatient care;
    6-3  and
    6-4                    (C)  the development and format of reports and
    6-5  information relating to provider quality.
    6-6        (h)  Members of the council do not receive a salary or per
    6-7  diem allowance for serving as members of the council but shall be
    6-8  reimbursed for actual and necessary expenses incurred in the
    6-9  performance of their duties, which may include reimbursement of
   6-10  travel and living expenses while engaged in council business.  A
   6-11  member of an advisory committee appointed by the council is not
   6-12  entitled to receive compensation or reimbursement for travel
   6-13  expenses.
   6-14        (i)  Appointments to the council shall be made without regard
   6-15  to the race, color, disability, sex, religion, age, or national
   6-16  origin of appointees.  Additionally, in making the appointments to
   6-17  the council, the governor shall consider geographical
   6-18  representation.
   6-19        (j)  A person may not serve as a member of the council if the
   6-20  person is required to register as a lobbyist under Chapter 305,
   6-21  Government Code, because of the person's activities for
   6-22  compensation on behalf of a profession related to the operation of
   6-23  the council.
   6-24        Sec. 108.004.  MEETINGS.  (a)  The council, council
   6-25  subcommittees, and technical advisory committees are subject to the
   6-26  open meetings law, Chapter 551, Government Code.
   6-27        (b)  The council shall meet as often as necessary, but not
    7-1  less often than quarterly, to perform its duties under this
    7-2  chapter.
    7-3        (c)  The council shall publish a notice of its meetings in at
    7-4  least four newspapers of general circulation in this state.
    7-5        Sec. 108.005.  TERMS.  (a)  The terms of the agency members
    7-6  are concurrent with their terms of office.  The appointed council
    7-7  members serve six-year staggered terms, with the terms of five
    7-8  members expiring September 1 of each odd-numbered year.
    7-9        (b)  An appointed member may not serve more than two full
   7-10  consecutive terms.
   7-11        (c)  It is a ground for removal from the council if a member
   7-12  of the council:
   7-13              (1)  does not have at the time of appointment the
   7-14  qualifications required by Section 108.003;
   7-15              (2)  does not maintain during service the
   7-16  qualifications required by Section 108.003;
   7-17              (3)  cannot discharge the member's duties for a
   7-18  substantial part of the term for which the member is appointed
   7-19  because of illness or disability; or
   7-20              (4)  fails to attend at least one-half of the regularly
   7-21  scheduled meetings that the member is eligible to attend during a
   7-22  calendar year.
   7-23        Sec. 108.006.  POWERS AND DUTIES OF COUNCIL.  (a)  The
   7-24  council shall develop a statewide health care data collection
   7-25  system to collect health care charges, utilization data, provider
   7-26  quality data, and outcome data to facilitate the promotion and
   7-27  accessibility of cost-effective, good quality health care.  The
    8-1  council shall:
    8-2              (1)  direct the collection, dissemination, and analysis
    8-3  of data under this chapter;
    8-4              (2)  contract with the department to collect the data
    8-5  under this chapter;
    8-6              (3)  adopt policies and rules necessary to carry out
    8-7  this chapter, including rules concerning data collection
    8-8  requirements;
    8-9              (4)  build on and not duplicate other data collection
   8-10  required by state or federal law, by an accreditation organization,
   8-11  or by board rule;
   8-12              (5)  working with appropriate agencies, review public
   8-13  health data collection programs in this state and recommend, where
   8-14  appropriate, consolidation of the programs and any legislation
   8-15  necessary to effect the consolidation;
   8-16              (6)  assure that data collected is made available and
   8-17  accessible to interested persons;
   8-18              (7)  prescribe by rule a format for all providers to
   8-19  submit data consistent with Section 108.009;
   8-20              (8)  adopt by rule and implement a methodology to
   8-21  collect and disseminate data reflecting provider quality in
   8-22  accordance with Section 108.010;
   8-23              (9)  make reports to the legislature, the governor, and
   8-24  the public on:
   8-25                    (A)  the charges and rate of change in the
   8-26  charges for health care services in this state;
   8-27                    (B)  the effectiveness of the council in carrying
    9-1  out the legislative intent of this chapter;
    9-2                    (C)  if applicable, any recommendations on the
    9-3  need for further legislation; and
    9-4                    (D)  the quality and effectiveness of health care
    9-5  and access to health care for all citizens of this state;
    9-6              (10)  develop an annual work plan and establish
    9-7  priorities to accomplish its duties;
    9-8              (11)  provide consumer education on the interpretation
    9-9  and understanding of the information that is released to the
   9-10  public; and
   9-11              (12)  work with the Department of Information Resources
   9-12  in developing and implementing the statewide health care data
   9-13  collection system and maintain consistency with Department of
   9-14  Information Resources standards.
   9-15        (b)  The council may:
   9-16              (1)  employ or contract with the department to employ
   9-17  an executive director and other staff, including administrative and
   9-18  legal personnel, necessary to comply with this chapter and rules
   9-19  adopted under this chapter;
   9-20              (2)  engage professional consultants as it considers
   9-21  necessary to the performance of its duties;
   9-22              (3)  adopt rules clarifying which health care
   9-23  facilities must provide data under this chapter; and
   9-24              (4)  apply for and receive any appropriation, donation,
   9-25  or other funds from the state or federal government or any other
   9-26  public or private source, subject to Section 108.016 and
   9-27  limitations and conditions provided by legislative appropriation.
   10-1        (c)  The council may not establish or recommend rates of
   10-2  payment for health care services.
   10-3        (d)  The council may not take an action that affects or
   10-4  relates to the validity, status, or terms of a department
   10-5  interagency agreement or a contract without the board's approval.
   10-6        (e)  In the collection of data, the council shall consider
   10-7  the research and initiatives being pursued by the United States
   10-8  Department of Health and Human Services and the Joint Commission on
   10-9  Accreditation of Healthcare Organizations to reduce potential
  10-10  duplication or inconsistencies.  The council may not adopt rules
  10-11  that conflict with or duplicate any federally mandated data
  10-12  collection programs or requirements of comparable scope.
  10-13        Sec. 108.007.  REVIEW POWERS.  (a)  The council, through the
  10-14  department and  subject to reasonable rules and guidelines, may:
  10-15              (1)  inspect documents and records used by data sources
  10-16  that are required to compile data and reports; and
  10-17              (2)  compel providers to produce accurate documents and
  10-18  records.
  10-19        (b)  The council may enter into a memorandum of understanding
  10-20  with a state agency, including the division of the Health and Human
  10-21  Services Commission responsible for the state Medicaid program, or
  10-22  with a school of public health or another institution of higher
  10-23  education, to share data and expertise, to obtain data for the
  10-24  council, or to make data available to the council.  An agreement
  10-25  entered into under this subsection must protect patient
  10-26  confidentiality.
  10-27        Sec. 108.008.  DUTIES OF DEPARTMENT.  (a)  The department, as
   11-1  the state health planning and development agency under Chapter 104,
   11-2  is responsible for the collection of data under Chapter 311.
   11-3        (b)  The department shall:
   11-4              (1)  contract with the council to collect data under
   11-5  this chapter;
   11-6              (2)  provide administrative and legal assistance to the
   11-7  council in accordance with rules adopted by the board after
   11-8  consulting with the council and set out in the contract with the
   11-9  council;
  11-10              (3)  coordinate administrative responsibilities with
  11-11  the council to avoid unnecessary duplication of the collection of
  11-12  data and other duties;
  11-13              (4)  give the council access to data collected by the
  11-14  department on request of the council;
  11-15              (5)  submit or assist in the council's budget request
  11-16  to the legislature; and
  11-17              (6)  work with the Department of Information Resources
  11-18  in developing and implementing the statewide health care data
  11-19  collection system and maintain consistency with Department of
  11-20  Information Resources standards.
  11-21        (c)  The department may not take an action that affects or
  11-22  relates to the validity, status, or terms of a council interagency
  11-23  agreement or a contract without the council's approval.
  11-24        Sec. 108.009.  DATA SUBMISSION AND COLLECTION.  (a)  The
  11-25  council may collect, and, except as provided by Subsections (c) and
  11-26  (d), providers shall submit to the council or another entity as
  11-27  determined by the council, all data required by this section.  The
   12-1  data shall be collected according to uniform submission formats,
   12-2  coding systems, and other technical specifications necessary to
   12-3  make the incoming data substantially valid, consistent, compatible,
   12-4  and manageable using electronic data processing, if available.
   12-5        (b)  The council shall adopt rules to implement the data
   12-6  submission requirements imposed by Subsection (a) in appropriate
   12-7  stages to allow for the development of efficient systems for the
   12-8  collection and submission of the data.
   12-9        (c)  A rural provider may, but is not required to, provide
  12-10  the data required by this section.
  12-11        (d)  The council may not collect data from individual
  12-12  physicians or from an entity that is composed entirely of
  12-13  physicians and that is a professional association organized under
  12-14  the Texas Professional Association Act (Article 1528f, Vernon's
  12-15  Texas Civil Statutes), a limited liability partnership organized
  12-16  under Section 3.08, Texas Revised Partnership Act (Article
  12-17  6132b-3.08, Vernon's Texas Civil Statutes), or a limited liability
  12-18  company organized under the Texas Limited Liability Company Act
  12-19  (Article 1528n, Vernon's Texas Civil Statutes), except to the
  12-20  extent the entity owns and operates a health care facility in this
  12-21  state.  This subsection does not prohibit the release of data about
  12-22  physicians that has been collected from a health care facility
  12-23  under this chapter.
  12-24        (e)  The council shall establish the department as the single
  12-25  collection point for receipt of data from providers.  With the
  12-26  approval of the council and the board, the department may transfer
  12-27  collection of any data required to be collected by the department
   13-1  under any other law to the statewide health care data collection
   13-2  system.
   13-3        (f)  The council may not require providers to submit data
   13-4  more frequently than quarterly, but providers may submit data on a
   13-5  more frequent basis.
   13-6        (g)  The council shall coordinate data collection with the
   13-7  data collection formats used by federally qualified health centers.
   13-8  To satisfy the requirements of this chapter:
   13-9              (1)  a federally qualified health center shall submit
  13-10  annually to the council a copy of the Medicaid cost report of
  13-11  federally qualified health centers; and
  13-12              (2)  a provider receiving federal funds under 42 U.S.C.
  13-13  Section 254b, 254c, or 256 shall submit annually to the council a
  13-14  copy of the Bureau of Common Reporting Requirements data report
  13-15  developed by the United States Public Health Service.
  13-16        (h)  The council shall, to the extent feasible, coordinate
  13-17  data collection with the data collection formats used by hospitals
  13-18  and other providers.  The council shall accept data in the format
  13-19  developed by the National Uniform Billing Committee (Uniform
  13-20  Hospital Billing Form UB 92) and HCFA-1500 or their successors or
  13-21  other universally accepted standardized forms approved by the
  13-22  council.
  13-23        (i)  The council shall develop by rule reasonable alternate
  13-24  data submission procedures for entities that do not possess
  13-25  electronic data processing capacity.
  13-26        (j)  The council shall collect data and disseminate reports
  13-27  reflecting provider quality in accordance with Section 108.010.
   14-1        (k)  In developing the statewide health care data collection
   14-2  system, the council shall identify health care data elements
   14-3  relating to health care charges, provider quality, payer type, the
   14-4  outcome data related to health care services, and the use of health
   14-5  care services by consumers.
   14-6        (l)  The council shall develop and implement a health care
   14-7  information plan to be used by the department to:
   14-8              (1)  support public health and preventive health
   14-9  initiatives;
  14-10              (2)  assist in the delivery of primary and preventive
  14-11  health care services;
  14-12              (3)  facilitate the establishment of appropriate
  14-13  benchmark data to measure performance improvements;
  14-14              (4)  establish and maintain a systematic approach for
  14-15  the collection, storage, and analysis of health care data for
  14-16  longitudinal, epidemiological, and policy impact studies; and
  14-17              (5)  develop and use system-based protocols to identify
  14-18  individuals and populations at risk.
  14-19        (m)  To the extent feasible, the council shall obtain from
  14-20  public records the information that is available from those
  14-21  records.
  14-22        (n)  The council shall develop the statewide health care data
  14-23  collection system in accordance with Department of Information
  14-24  Resources standards.
  14-25        Sec. 108.010.  COLLECTION AND DISSEMINATION OF PROVIDER
  14-26  QUALITY DATA.  (a)  Subject to Section 108.009, the council shall
  14-27  collect data reflecting provider quality based on a methodology and
   15-1  review process established through the council's rulemaking
   15-2  process.  The methodology shall identify and measure quality
   15-3  standards and adhere to any federal mandates.
   15-4        (b)  After a majority of the council has been appointed, the
   15-5  council shall study and analyze initial methodologies for obtaining
   15-6  provider quality data.  The council shall adopt an initial
   15-7  methodology not later than January 1, 1997, but may not adopt the
   15-8  initial methodology before the first anniversary of the date on
   15-9  which a majority of the council is appointed.  If the council
  15-10  determines additional time for development of the initial
  15-11  methodology is needed, the council, by a two-thirds vote of the
  15-12  full council, may extend the deadline established by this
  15-13  subsection for adopting the initial methodology.
  15-14        (c)  The methodology must be consistent with other data
  15-15  collection methods used in this state, including methods used by
  15-16  health maintenance organizations such as the Health Plan Employer
  15-17  Data Information SET (HEDIS) provided by the National Committee on
  15-18  Quality Assurance, or other universally accepted methods approved
  15-19  by the council.
  15-20        (d)  The council shall test the methodology by collecting
  15-21  provider quality data for one year, subject to Section 108.009.
  15-22  The council may test using pilot methodologies.  After collecting
  15-23  provider quality data for one year, the council shall report
  15-24  findings applicable to a provider to that provider and allow the
  15-25  provider to review and comment on the initial quality outcome data
  15-26  applicable to that provider.  The council shall verify the accuracy
  15-27  of the data during this review and revision process.  After the
   16-1  review and revision process, quality outcome data for subsequent
   16-2  reports shall be published and made available to the public, on a
   16-3  time schedule the council considers appropriate.
   16-4        (e)  If the council determines that quality outcome data to
   16-5  be published under Subsection (d) does not provide the intended
   16-6  result or is inaccurate or inappropriate for dissemination, the
   16-7  council is not required to publish the data or reports based in
   16-8  whole or in part on the data.  This subsection does not affect the
   16-9  release of data collected under Section 108.009.
  16-10        (f)  The council shall adopt rules allowing a provider to
  16-11  submit written comments regarding any specific data to be released
  16-12  concerning the provider.  The comments may be attached to any
  16-13  public release of data.
  16-14        (g)  The methodology adopted by the council for measuring
  16-15  quality shall include case-mix qualifiers, severity adjustment
  16-16  factors, and any other factors necessary to accurately reflect
  16-17  provider quality.
  16-18        (h)  In addition to the requirements of this section, any
  16-19  release of provider quality data shall comply with Sections
  16-20  108.011(d)-(f).
  16-21        (i)  A quality outcome data report may not identify an
  16-22  individual physician by name, but may identify the physician by the
  16-23  uniform physician identifier designated by the council under
  16-24  Section 108.011(c).
  16-25        Sec. 108.011.  DATA DISSEMINATION AND PUBLICATION.  (a)  The
  16-26  council shall promptly provide data to those requesting it, subject
  16-27  to the restrictions on access to council data prescribed by
   17-1  Sections 108.010 and 108.013.
   17-2        (b)  Subject to the restrictions on access to council data
   17-3  prescribed by Sections 108.010 and 108.013, and using the data
   17-4  collected under Section 108.009 and other data, records, and
   17-5  matters of record available to it, the council shall prepare and
   17-6  issue reports to the governor, the legislature, and the public as
   17-7  provided by this section and Section 108.006(a).  The council must
   17-8  issue the reports at least annually.
   17-9        (c)  Subject to the restrictions on access to council data
  17-10  prescribed by Sections 108.010 and 108.013, the council shall
  17-11  prepare and issue reports that provide information relating to
  17-12  providers, such as the incidence rate of selected medical or
  17-13  surgical procedures and the provider quality.  The reports must
  17-14  provide the data in a manner that identifies individual providers
  17-15  and that identifies and compares data elements for all providers.
  17-16  Individual physicians may not be identified by name, but shall be
  17-17  identified by uniform physician identifiers.  The council by rule
  17-18  shall designate the characters to be used as uniform physician
  17-19  identifiers.
  17-20        (d)  The council shall adopt procedures to verify the
  17-21  accuracy of the data before a report containing the data is
  17-22  released to the public.
  17-23        (e)  If provider data is requested from the council for a
  17-24  specific provider, the council shall notify the provider about the
  17-25  release of the data.  This subsection does not authorize the
  17-26  provider to interfere with the release of that data.
  17-27        (f)  A report issued by the council shall include a
   18-1  reasonable review and comment period before final publication of
   18-2  the report.
   18-3        Sec. 108.012.  COMPUTER ACCESS TO DATA.  (a)  The council
   18-4  shall provide a means for computer-to-computer access to the data.
   18-5  All reports shall maintain patient confidentiality as provided by
   18-6  Section 108.013.
   18-7        (b)  The council may charge a person requesting data a fee
   18-8  for the data.  The fees may reflect the quantity of information
   18-9  provided and the expense incurred by the council in collecting and
  18-10  providing the data.  Fees collected under this section shall be
  18-11  deposited in the designated account in the general revenue fund
  18-12  created in Section 108.015.  The council may not charge a fee for
  18-13  providing data to another state agency.
  18-14        Sec. 108.013.  CONFIDENTIALITY AND GENERAL ACCESS TO DATA.
  18-15  (a)  The data received by the council shall be used by the council
  18-16  for the benefit of the public.   The council is subject to the open
  18-17  records law, Chapter 552, Government Code.  Subject to specific
  18-18  limitations established by this chapter and council rule, the
  18-19  council shall make determinations on requests for information in
  18-20  favor of access.
  18-21        (b)  The council by rule shall designate the characters to be
  18-22  used by providers as uniform patient identifiers.
  18-23        (c)  Unless specifically authorized by this chapter, the
  18-24  council may not release and a person or entity may not gain access
  18-25  to any data:
  18-26              (1)  that could reasonably be expected to reveal the
  18-27  identity of a patient or physician or that reveals the zip code of
   19-1  a patient's primary residence;
   19-2              (2)  disclosing provider discounts or differentials
   19-3  between payments and billed charges; or
   19-4              (3)  relating to actual payments to an identified
   19-5  provider made by a payer.
   19-6        (d)  All data collected and used by the department and the
   19-7  council under this chapter is subject to the confidentiality
   19-8  provisions and criminal penalties of:
   19-9              (1)  Section 311.037;
  19-10              (2)  Section 81.103; and
  19-11              (3)  Section 5.08, Medical Practice Act (Article 4495b,
  19-12  Vernon's Texas Civil Statutes).
  19-13        (e)  Data on patients and physicians and compilations,
  19-14  reports, or analyses produced from the data collected that identify
  19-15  patients and physicians are not:
  19-16              (1)  subject to discovery, subpoena, or other means of
  19-17  legal compulsion for release to any person or entity except as
  19-18  provided by this section; or
  19-19              (2)  admissible in any civil, administrative, or
  19-20  criminal proceeding.
  19-21        (f)  Notwithstanding Subsection (c)(1), the council may use
  19-22  zip code information to analyze data on a geographic basis.
  19-23        Sec. 108.014.  CIVIL PENALTY.  (a)  A person who knowingly or
  19-24  negligently releases data in violation of this chapter is liable
  19-25  for a civil penalty of not more than $10,000.
  19-26        (b)  A person who fails to supply available data under
  19-27  Sections 108.009 and 108.010 is liable for a civil penalty of not
   20-1  less than $1,000 or more than $10,000 for each act of violation.
   20-2        (c)  The attorney general, at the request of the council,
   20-3  shall enforce this chapter.
   20-4        Sec. 108.015.  DESIGNATED ACCOUNT.  A designated account is
   20-5  in the general revenue fund for all grants and contributions of
   20-6  money to the council and all fees collected by the council.
   20-7  Designated account funds shall be carried over from fiscal year to
   20-8  fiscal year and from biennium to biennium.
   20-9        Sec. 108.016.  CONFLICT OF INTEREST.  The council may not
  20-10  accept a donation from a person required to provide data under this
  20-11  chapter or from a person or business entity who provides goods or
  20-12  services to the council for compensation.
  20-13        SECTION 2.  Section 311.032(a), Health and Safety Code, is
  20-14  amended to read as follows:
  20-15        (a)  The department shall establish a uniform reporting and
  20-16  collection system for hospital financial and<,> utilization<, and
  20-17  patient discharge> data.
  20-18        SECTION 3.  Section 311.035(c), Health and Safety Code, is
  20-19  amended to read as follows:
  20-20        (c)  The department shall enter into an interagency agreement
  20-21  with the Texas Department of Mental Health and Mental Retardation,
  20-22  Texas Commission on Alcohol and Drug Abuse, and Texas Department of
  20-23  Insurance relating to the mental health and chemical dependency
  20-24  <hospital discharge> data collected under Section 311.0335.  The
  20-25  agreement shall address the collection, analysis, and sharing of
  20-26  the data by the agencies.
  20-27        SECTION 4.  Subchapter C, Chapter 2054, Government Code, is
   21-1  amended by adding Section 2054.0541 to read as follows:
   21-2        Sec. 2054.0541.  STATEWIDE HEALTH CARE DATA COLLECTION
   21-3  SYSTEM.  The department shall assist the Texas Health Care
   21-4  Information Council and the Texas Department of Health with
   21-5  planning, analyses, and management functions relating to the
   21-6  procurement, use, and implementation of a statewide health care
   21-7  data collection system under Chapter 108, Health and Safety Code.
   21-8        SECTION 5.  The following laws are repealed:
   21-9              (1)  Section 311.035(b), Health and Safety Code; and
  21-10              (2)  Section 311.034, Health and Safety Code.
  21-11        SECTION 6.  (a)  The governor shall make appointments to the
  21-12  Texas Health Care Information Council as soon as practicable after
  21-13  the effective date of this Act.
  21-14        (b)  The governor shall make the initial appointments to the
  21-15  Texas Health Care Information Council as follows:
  21-16              (1)  one representative of business, one representative
  21-17  from labor, one representative of hospitals, one representative of
  21-18  physicians, and one non-health-care professional member serve terms
  21-19  expiring September 1, 1997;
  21-20              (2)  one representative of business, one consumer
  21-21  representative, one representative of physicians, one
  21-22  representative of hospitals, and the representative of a health
  21-23  maintenance organization serve terms expiring September 1, 1999;
  21-24  and
  21-25              (3)  one representative from labor, one representative
  21-26  of business, one consumer representative, one representative of
  21-27  physicians, and one non-health-care professional member serve terms
   22-1  expiring September 1, 2001.
   22-2        SECTION 7.  Not later than December 1, 1996, the Texas Health
   22-3  Care Information Council appointed under Chapter 108, Health and
   22-4  Safety Code, as added by this Act, shall make recommendations under
   22-5  Section 108.006(a)(5) of that code relating to consolidation of
   22-6  health data collection programs existing on the effective date of
   22-7  this Act, together with proposed legislation necessary to effect
   22-8  any recommended consolidation.
   22-9        SECTION 8.  This Act takes effect September 1, 1995.
  22-10        SECTION 9.  The importance of this legislation and the
  22-11  crowded condition of the calendars in both houses create an
  22-12  emergency and an imperative public necessity that the
  22-13  constitutional rule requiring bills to be read on three several
  22-14  days in each house be suspended, and this rule is hereby suspended.