1-1 By: Maxey, et al. (Senate Sponsor - Patterson) H.B. No. 1048
1-2 (In the Senate - Received from the House April 27, 1995;
1-3 May 1, 1995, read first time and referred to Committee on Health
1-4 and Human Services; May 17, 1995, reported adversely, with
1-5 favorable Committee Substitute by the following vote: Yeas 9, Nays
1-6 0; May 17, 1995, sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR H.B. No. 1048 By: Patterson
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to the creation of the Texas Health Care Information
1-11 Council; providing civil penalties.
1-12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-13 SECTION 1. Subtitle E, Title 2, Health and Safety Code, is
1-14 amended by adding Chapter 108 to read as follows:
1-15 CHAPTER 108. TEXAS HEALTH CARE INFORMATION COUNCIL
1-16 Sec. 108.001. CREATION OF COUNCIL. The Texas Health Care
1-17 Information Council shall administer this chapter and report to the
1-18 governor, the legislature, and the public.
1-19 Sec. 108.002. DEFINITIONS. In this chapter:
1-20 (1) "Board" means the Texas Board of Health.
1-21 (2) "Charge" or "rate" means the amount billed by a
1-22 provider for specific procedures or services provided to a patient
1-23 before any adjustment for contractual allowances. The term does
1-24 not include copayment charges to health maintenance organization
1-25 enrollees by providers paid by capitation or salary in a health
1-26 maintenance organization.
1-27 (3) "Council" means the Texas Health Care Information
1-28 Council.
1-29 (4) "Data" means information collected under Section
1-30 108.009 in the form initially received.
1-31 (5) "Department" means the Texas Department of Health.
1-32 (6) "Health care facility" means:
1-33 (A) a hospital;
1-34 (B) an ambulatory surgical center licensed under
1-35 Chapter 243;
1-36 (C) a chemical dependency treatment facility
1-37 licensed under Chapter 464;
1-38 (D) a renal dialysis facility;
1-39 (E) a birthing center;
1-40 (F) a rural health clinic; or
1-41 (G) a federally qualified health center as
1-42 defined by 42 U.S.C. Section 1396d(l)(2)(B).
1-43 (7) "Health maintenance organization" means an
1-44 organization as defined in Section 2, Texas Health Maintenance
1-45 Organization Act (Article 20A.02, Vernon's Texas Insurance Code).
1-46 (8) "Hospital" means a public, for-profit, or
1-47 nonprofit institution licensed or owned by this state that is a
1-48 general or special hospital, private mental hospital, chronic
1-49 disease hospital, or other type of hospital.
1-50 (9) "Outcome data" means measures related to the
1-51 provision of care, including:
1-52 (A) patient demographic information;
1-53 (B) patient length of stay;
1-54 (C) mortality;
1-55 (D) co-morbidity;
1-56 (E) complications; and
1-57 (F) charges.
1-58 (10) "Physician" means an individual licensed under
1-59 the laws of this state to practice medicine under the Medical
1-60 Practice Act (Article 4495b, Vernon's Texas Civil Statutes).
1-61 (11) "Provider" means a physician, health care
1-62 facility, or health maintenance organization.
1-63 (12) "Provider quality" means the extent to which a
1-64 provider renders care that, within the capabilities of modern
1-65 medicine, obtains for patients medically acceptable health outcomes
1-66 and prognoses, after severity adjustment.
1-67 (13) "Rural provider" means a provider located in:
1-68 (A) a county with a population of not more than
2-1 35,000;
2-2 (B) those portions of extended cities that the
2-3 United States Bureau of the Census has determined to be rural; or
2-4 (C) an area that is not delineated as an
2-5 urbanized area by the United States Bureau of the Census.
2-6 (14) "Severity adjustment" means a method to stratify
2-7 patient groups by degrees of illness and mortality.
2-8 (15) "Uniform patient identifier" means a number
2-9 assigned to an individual patient and composed of numeric, alpha,
2-10 or alphanumeric characters.
2-11 (16) "Uniform physician identifier" means a number
2-12 assigned to an individual physician and composed of numeric, alpha,
2-13 or alphanumeric characters.
2-14 Sec. 108.003. COUNCIL COMPOSITION; EXPENSES. (a) The
2-15 council is composed of three nonvoting ex officio state agency
2-16 members and 15 members appointed by the governor in accordance with
2-17 this section.
2-18 (b) The nonvoting ex officio members of the council are:
2-19 (1) the commissioner of public health;
2-20 (2) the commissioner of health and human services; and
2-21 (3) the commissioner of insurance.
2-22 (c) The governor shall appoint the following members of the
2-23 council:
2-24 (1) three representatives of the business community,
2-25 with at least one representing small businesses, who are purchasers
2-26 of health care but who are not involved in the provision of health
2-27 care or health insurance;
2-28 (2) two representatives from labor, one of whom is not
2-29 directly involved with management of health care benefits;
2-30 (3) two representatives of consumers who are not
2-31 professionally involved in the purchase, provision, administration,
2-32 or review of health care or health care insurance;
2-33 (4) two representatives of hospitals;
2-34 (5) one representative of health maintenance
2-35 organizations;
2-36 (6) three representatives of physicians who are
2-37 involved in direct patient care; and
2-38 (7) two members who are not professionally involved in
2-39 the purchase, provision, administration, or review of health care
2-40 or health care insurance and who have expertise in:
2-41 (A) health planning;
2-42 (B) health economics;
2-43 (C) provider quality assurance;
2-44 (D) statistics or health data management; or
2-45 (E) the reimbursement of medical education and
2-46 research costs.
2-47 (d) The chairman is appointed by and serves at the pleasure
2-48 of the governor. Members annually shall elect a vice chairman.
2-49 (e) A majority of voting members constitutes a quorum for
2-50 the transaction of any business. An act by the majority of the
2-51 voting members present at any meeting at which there is a quorum is
2-52 considered to be an act of the council.
2-53 (f) The council may appoint subcommittees and may elect any
2-54 officers subordinate to those provided for in Subsection (d).
2-55 (g) The council shall appoint technical advisory committees.
2-56 The technical advisory committees shall work in coordination with
2-57 each other and may consult with other professionals, as necessary.
2-58 The technical advisory committees shall include:
2-59 (1) a technical advisory committee that includes,
2-60 among other individuals, at least five practicing physicians
2-61 licensed in this state to provide advice and recommendations to the
2-62 council on:
2-63 (A) the development and implementation of the
2-64 methodology and the interpretation of provider quality data under
2-65 Section 108.010; and
2-66 (B) the development and dissemination of
2-67 consumer education information and materials;
2-68 (2) a technical advisory committee composed of at
2-69 least five practicing physicians licensed in this state who have
2-70 been actively engaged in organized peer review at a hospital in
3-1 this state to provide advice, recommendations, and peer review
3-2 expertise to the council on:
3-3 (A) the use of peer review in the determination
3-4 of quality inpatient care;
3-5 (B) the development and interpretation of data
3-6 elements necessary to the determination of quality inpatient care;
3-7 and
3-8 (C) the development and format of reports and
3-9 information relating to provider quality;
3-10 (3) a technical advisory committee composed of
3-11 individuals who have expertise in the reimbursement of medical
3-12 education and research costs; and
3-13 (4) a technical advisory committee composed of
3-14 representatives of health maintenance organizations to assist the
3-15 council in complying with Section 108.009(o).
3-16 (h) A member of the council may not receive compensation for
3-17 service on the council. However, the member shall be reimbursed
3-18 for the member's actual and necessary meals, lodging,
3-19 transportation, and incidental expenses if incurred while
3-20 performing council business.
3-21 (i) A member of an advisory committee appointed by the
3-22 council may not receive compensation or reimbursement of any
3-23 expense incurred while serving on the committee.
3-24 (j) Appointments to the council shall be made without regard
3-25 to the race, color, disability, sex, religion, age, or national
3-26 origin of appointees. Additionally, in making the appointments to
3-27 the council, the governor shall consider geographical
3-28 representation.
3-29 (k) A person may not serve as a member of the council if the
3-30 person is required to register as a lobbyist under Chapter 305,
3-31 Government Code, because of the person's activities for
3-32 compensation on behalf of a profession related to the operation of
3-33 the council.
3-34 Sec. 108.004. MEETINGS. (a) The council, council
3-35 subcommittees, and technical advisory committees are subject to the
3-36 open meetings law, Chapter 551, Government Code.
3-37 (b) The council shall meet as often as necessary, but not
3-38 less often than quarterly, to perform its duties under this
3-39 chapter.
3-40 (c) The council shall publish a notice of its meetings in at
3-41 least four newspapers of general circulation in this state.
3-42 Sec. 108.005. TERMS. (a) The terms of the agency members
3-43 are concurrent with their terms of office. The appointed council
3-44 members serve six-year staggered terms, with the terms of five
3-45 members expiring September 1 of each odd-numbered year.
3-46 (b) An appointed member may not serve more than two full
3-47 consecutive terms.
3-48 (c) It is a ground for removal from the council if a member
3-49 of the council:
3-50 (1) does not have at the time of appointment the
3-51 qualifications required by Section 108.003;
3-52 (2) does not maintain during service the
3-53 qualifications required by Section 108.003;
3-54 (3) cannot discharge the member's duties for a
3-55 substantial part of the term for which the member is appointed
3-56 because of illness or disability; or
3-57 (4) fails to attend at least one-half of the regularly
3-58 scheduled meetings that the member is eligible to attend during a
3-59 calendar year.
3-60 Sec. 108.006. POWERS AND DUTIES OF COUNCIL. (a) The
3-61 council shall develop a statewide health care data collection
3-62 system to collect health care charges, utilization data, provider
3-63 quality data, and outcome data to facilitate the promotion and
3-64 accessibility of cost-effective, good quality health care. The
3-65 council shall:
3-66 (1) direct the collection, dissemination, and analysis
3-67 of data under this chapter;
3-68 (2) contract with the department to collect the data
3-69 under this chapter;
3-70 (3) adopt policies and rules necessary to carry out
4-1 this chapter, including rules concerning data collection
4-2 requirements;
4-3 (4) build on and not duplicate other data collection
4-4 required by state or federal law, by an accreditation organization,
4-5 or by board rule;
4-6 (5) working with appropriate agencies, review public
4-7 health data collection programs in this state and recommend, where
4-8 appropriate, consolidation of the programs and any legislation
4-9 necessary to effect the consolidation;
4-10 (6) assure that data collected is made available and
4-11 accessible to interested persons;
4-12 (7) prescribe by rule a format for providers to submit
4-13 data consistent with Section 108.009;
4-14 (8) adopt by rule and implement a methodology to
4-15 collect and disseminate data reflecting provider quality in
4-16 accordance with Section 108.010;
4-17 (9) make reports to the legislature, the governor, and
4-18 the public on:
4-19 (A) the charges and rate of change in the
4-20 charges for health care services in this state;
4-21 (B) the effectiveness of the council in carrying
4-22 out the legislative intent of this chapter;
4-23 (C) if applicable, any recommendations on the
4-24 need for further legislation; and
4-25 (D) the quality and effectiveness of health care
4-26 and access to health care for all citizens of this state;
4-27 (10) develop an annual work plan and establish
4-28 priorities to accomplish its duties;
4-29 (11) provide consumer education on the interpretation
4-30 and understanding of the information that is released to the
4-31 public;
4-32 (12) work with the Health and Human Services
4-33 Commission and each health and human services agency that
4-34 administers a part of the state Medicaid program to avoid
4-35 duplication of expenditures of state funds for computer systems,
4-36 staff, or services in the collection and analysis of data relating
4-37 to the state Medicaid program; and
4-38 (13) work with the Department of Information Resources
4-39 in developing and implementing the statewide health care data
4-40 collection system and maintain consistency with Department of
4-41 Information Resources standards.
4-42 (b) The council may:
4-43 (1) employ or contract with the department to employ
4-44 an executive director and other staff, including administrative and
4-45 legal personnel, necessary to comply with this chapter and rules
4-46 adopted under this chapter;
4-47 (2) engage professional consultants as it considers
4-48 necessary to the performance of its duties;
4-49 (3) adopt rules clarifying which health care
4-50 facilities must provide data under this chapter; and
4-51 (4) apply for and receive any appropriation, donation,
4-52 or other funds from the state or federal government or any other
4-53 public or private source, subject to Section 108.015 and
4-54 limitations and conditions provided by legislative appropriation.
4-55 (c) The council may not establish or recommend rates of
4-56 payment for health care services.
4-57 (d) The council may not take an action that affects or
4-58 relates to the validity, status, or terms of a department
4-59 interagency agreement or a contract without the board's approval.
4-60 (e) In the collection of data, the council shall consider
4-61 the research and initiatives being pursued by the United States
4-62 Department of Health and Human Services, the National Committee for
4-63 Quality Assurance, and the Joint Commission on Accreditation of
4-64 Healthcare Organizations to reduce potential duplication or
4-65 inconsistencies. The council may not adopt rules that conflict
4-66 with or duplicate any federally mandated data collection programs
4-67 or requirements of comparable scope.
4-68 Sec. 108.007. REVIEW POWERS. (a) The council, through the
4-69 department and subject to reasonable rules and guidelines, may:
4-70 (1) inspect documents and records used by data sources
5-1 that are required to compile data and reports; and
5-2 (2) compel providers to produce accurate documents and
5-3 records.
5-4 (b) The council may enter into a memorandum of understanding
5-5 with a state agency, including the division of the Health and Human
5-6 Services Commission responsible for the state Medicaid program, or
5-7 with a school of public health or another institution of higher
5-8 education, to share data and expertise, to obtain data for the
5-9 council, or to make data available to the council. An agreement
5-10 entered into under this subsection must protect patient
5-11 confidentiality.
5-12 Sec. 108.008. DUTIES OF DEPARTMENT. (a) The department, as
5-13 the state health planning and development agency under Chapter 104,
5-14 is responsible for the collection of data under Chapter 311.
5-15 (b) The department shall:
5-16 (1) contract with the council to collect data under
5-17 this chapter;
5-18 (2) provide administrative and legal assistance to the
5-19 council in accordance with rules adopted by the board after
5-20 consulting with the council and set out in the contract with the
5-21 council;
5-22 (3) coordinate administrative responsibilities with
5-23 the council to avoid unnecessary duplication of the collection of
5-24 data and other duties;
5-25 (4) give the council access to data collected by the
5-26 department on request of the council;
5-27 (5) submit or assist in the council's budget request
5-28 to the legislature; and
5-29 (6) work with the Department of Information Resources
5-30 in developing and implementing the statewide health care data
5-31 collection system and maintain consistency with Department of
5-32 Information Resources standards.
5-33 (c) The department may not take an action that affects or
5-34 relates to the validity, status, or terms of a council interagency
5-35 agreement or a contract without the council's approval.
5-36 Sec. 108.009. DATA SUBMISSION AND COLLECTION. (a) The
5-37 council may collect, and, except as provided by Subsections (c) and
5-38 (d), providers shall submit to the council or another entity as
5-39 determined by the council, all data required by this section. The
5-40 data shall be collected according to uniform submission formats,
5-41 coding systems, and other technical specifications necessary to
5-42 make the incoming data substantially valid, consistent, compatible,
5-43 and manageable using electronic data processing, if available.
5-44 (b) The council shall adopt rules to implement the data
5-45 submission requirements imposed by Subsection (a) in appropriate
5-46 stages to allow for the development of efficient systems for the
5-47 collection and submission of the data.
5-48 (c) A rural provider may, but is not required to, provide
5-49 the data required by this section.
5-50 (d) The council may not collect data from individual
5-51 physicians or from an entity that is composed entirely of
5-52 physicians and that is a professional association organized under
5-53 the Texas Professional Association Act (Article 1528f, Vernon's
5-54 Texas Civil Statutes), a limited liability partnership organized
5-55 under Section 3.08, Texas Revised Partnership Act (Article
5-56 6132b-3.08, Vernon's Texas Civil Statutes), or a limited liability
5-57 company organized under the Texas Limited Liability Company Act
5-58 (Article 1528n, Vernon's Texas Civil Statutes), except to the
5-59 extent the entity owns and operates a health care facility in this
5-60 state. This subsection does not prohibit the release of data about
5-61 physicians that has been collected from a health care facility
5-62 under this chapter.
5-63 (e) The council shall establish the department as the single
5-64 collection point for receipt of data from providers. With the
5-65 approval of the council and the board, the department may transfer
5-66 collection of any data required to be collected by the department
5-67 under any other law to the statewide health care data collection
5-68 system.
5-69 (f) The council may not require providers to submit data
5-70 more frequently than quarterly, but providers may submit data on a
6-1 more frequent basis.
6-2 (g) The council shall coordinate data collection with the
6-3 data collection formats used by federally qualified health centers.
6-4 To satisfy the requirements of this chapter:
6-5 (1) a federally qualified health center shall submit
6-6 annually to the council a copy of the Medicaid cost report of
6-7 federally qualified health centers; and
6-8 (2) a provider receiving federal funds under 42 U.S.C.
6-9 Section 254b, 254c, or 256 shall submit annually to the council a
6-10 copy of the Bureau of Common Reporting Requirements data report
6-11 developed by the United States Public Health Service.
6-12 (h) The council shall, to the extent feasible, coordinate
6-13 data collection with the data collection formats used by hospitals
6-14 and other providers. The council shall accept data in the format
6-15 developed by the National Uniform Billing Committee (Uniform
6-16 Hospital Billing Form UB 92) and HCFA-1500 or their successors or
6-17 other universally accepted standardized forms approved by the
6-18 council.
6-19 (i) The council shall develop by rule reasonable alternate
6-20 data submission procedures for providers that do not possess
6-21 electronic data processing capacity.
6-22 (j) The council shall collect data and disseminate reports
6-23 reflecting provider quality in accordance with Section 108.010.
6-24 (k) In developing the statewide health care data collection
6-25 system, the council shall identify health care data elements
6-26 relating to health care charges, provider quality, payer type, the
6-27 outcome data related to health care services, and the use of health
6-28 care services by consumers.
6-29 (l) The council shall develop and implement a health care
6-30 information plan to be used by the department to:
6-31 (1) support public health and preventive health
6-32 initiatives;
6-33 (2) assist in the delivery of primary and preventive
6-34 health care services;
6-35 (3) facilitate the establishment of appropriate
6-36 benchmark data to measure performance improvements;
6-37 (4) establish and maintain a systematic approach for
6-38 the collection, storage, and analysis of health care data for
6-39 longitudinal, epidemiological, and policy impact studies; and
6-40 (5) develop and use system-based protocols to identify
6-41 individuals and populations at risk.
6-42 (m) To the extent feasible, the council shall obtain from
6-43 public records the information that is available from those
6-44 records.
6-45 (n) The council shall develop the statewide health care data
6-46 collection system in accordance with Department of Information
6-47 Resources standards.
6-48 (o) A health maintenance organization shall annually submit
6-49 to the council aggregate data by service area required by the
6-50 Health Plan Employer Data Information Set (HEDIS) as operated by
6-51 the National Committee for Quality Assurance. The council may
6-52 approve the submission of data in accordance with other methods
6-53 generally used by the health maintenance organization industry.
6-54 This subsection does not relieve a health care facility that
6-55 provides services to a health maintenance organization from the
6-56 requirements of this chapter.
6-57 Sec. 108.010. COLLECTION AND DISSEMINATION OF PROVIDER
6-58 QUALITY DATA. (a) Subject to Section 108.009, the council shall
6-59 collect data reflecting provider quality based on a methodology and
6-60 review process established through the council's rulemaking
6-61 process. The methodology shall identify and measure quality
6-62 standards and adhere to any federal mandates.
6-63 (b) After a majority of the council has been appointed, the
6-64 council shall study and analyze initial methodologies for obtaining
6-65 provider quality data. The council shall adopt an initial
6-66 methodology not later than January 1, 1997, but may not adopt the
6-67 initial methodology before the first anniversary of the date on
6-68 which a majority of the council is appointed. If the council
6-69 determines additional time for development of the initial
6-70 methodology is needed, the council, by a two-thirds vote of the
7-1 full council, may extend the deadline established by this
7-2 subsection for adopting the initial methodology.
7-3 (c) The council shall test the methodology by collecting
7-4 provider quality data for one year, subject to Section 108.009.
7-5 The council may test using pilot methodologies. After collecting
7-6 provider quality data for one year, the council shall report
7-7 findings applicable to a provider to that provider and allow the
7-8 provider to review and comment on the initial quality outcome data
7-9 applicable to that provider. The council shall verify the accuracy
7-10 of the data during this review and revision process. After the
7-11 review and revision process, quality outcome data for subsequent
7-12 reports shall be published and made available to the public, on a
7-13 time schedule the council considers appropriate.
7-14 (d) If the council determines that quality outcome data to
7-15 be published under Subsection (c) does not provide the intended
7-16 result or is inaccurate or inappropriate for dissemination, the
7-17 council is not required to publish the data or reports based in
7-18 whole or in part on the data. This subsection does not affect the
7-19 release of data collected under Section 108.009.
7-20 (e) The council shall adopt rules allowing a provider to
7-21 submit written comments regarding any specific data to be released
7-22 concerning the provider. The comments may be attached to any
7-23 public release of data.
7-24 (f) The methodology adopted by the council for measuring
7-25 quality shall include case-mix qualifiers, severity adjustment
7-26 factors, adjustments for medical education and research, and any
7-27 other factors necessary to accurately reflect provider quality.
7-28 (g) In addition to the requirements of this section, any
7-29 release of provider quality data shall comply with Sections
7-30 108.011(d)-(f).
7-31 (h) A quality outcome data report may not identify an
7-32 individual physician by name, but must identify the physician by
7-33 the uniform physician identifier designated by the council under
7-34 Section 108.011(c).
7-35 Sec. 108.011. DATA DISSEMINATION AND PUBLICATION. (a) The
7-36 council shall promptly provide data to those requesting it, subject
7-37 to the restrictions on access to council data prescribed by
7-38 Sections 108.010 and 108.013.
7-39 (b) Subject to the restrictions on access to council data
7-40 prescribed by Sections 108.010 and 108.013, and using the data
7-41 collected under Section 108.009 and other data, records, and
7-42 matters of record available to it, the council shall prepare and
7-43 issue reports to the governor, the legislature, and the public as
7-44 provided by this section and Section 108.006(a). The council must
7-45 issue the reports at least annually.
7-46 (c) Subject to the restrictions on access to council data
7-47 prescribed by Sections 108.010 and 108.013, the council shall
7-48 prepare and issue reports that provide information relating to
7-49 providers, such as the incidence rate of selected medical or
7-50 surgical procedures and the provider quality. The reports must
7-51 provide the data in a manner that identifies individual providers
7-52 and that identifies and compares data elements for all providers.
7-53 Individual physicians may not be identified by name, but shall be
7-54 identified by uniform physician identifiers. The council by rule
7-55 shall designate the characters to be used as uniform physician
7-56 identifiers.
7-57 (d) The council shall adopt procedures to verify the
7-58 accuracy of the data before a report containing the data is
7-59 released to the public.
7-60 (e) If provider data is requested from the council for a
7-61 specific provider, the council shall notify the provider about the
7-62 release of the data. This subsection does not authorize the
7-63 provider to interfere with the release of that data.
7-64 (f) A report issued by the council shall include a
7-65 reasonable review and comment period for the affected providers
7-66 before public release of the report.
7-67 Sec. 108.012. COMPUTER ACCESS TO DATA. (a) The council
7-68 shall provide a means for computer-to-computer access to the data.
7-69 All reports shall maintain patient confidentiality as provided by
7-70 Section 108.013.
8-1 (b) The council may charge a person requesting data a fee
8-2 for the data. The fees may reflect the quantity of information
8-3 provided and the expense incurred by the council in collecting and
8-4 providing the data and shall be set at a level that will raise
8-5 revenue sufficient for the operation of the council. The council
8-6 may not charge a fee for providing data to another state agency.
8-7 Sec. 108.013. CONFIDENTIALITY AND GENERAL ACCESS TO DATA.
8-8 (a) The data received by the council shall be used by the council
8-9 for the benefit of the public. The council is subject to the open
8-10 records law, Chapter 552, Government Code. Subject to specific
8-11 limitations established by this chapter and council rule, the
8-12 council shall make determinations on requests for information in
8-13 favor of access.
8-14 (b) The council by rule shall designate the characters to be
8-15 used by providers as uniform patient identifiers.
8-16 (c) Unless specifically authorized by this chapter, the
8-17 council may not release and a person or entity may not gain access
8-18 to any data:
8-19 (1) that could reasonably be expected to reveal the
8-20 identity of a patient or physician or that reveals the zip code of
8-21 a patient's primary residence;
8-22 (2) disclosing provider discounts or differentials
8-23 between payments and billed charges; or
8-24 (3) relating to actual payments to an identified
8-25 provider made by a payer.
8-26 (d) All data collected and used by the department and the
8-27 council under this chapter is subject to the confidentiality
8-28 provisions and criminal penalties of:
8-29 (1) Section 311.037;
8-30 (2) Section 81.103; and
8-31 (3) Section 5.08, Medical Practice Act (Article 4495b,
8-32 Vernon's Texas Civil Statutes).
8-33 (e) Data on patients and physicians and compilations,
8-34 reports, or analyses produced from the data collected that identify
8-35 patients and physicians are not:
8-36 (1) subject to discovery, subpoena, or other means of
8-37 legal compulsion for release to any person or entity except as
8-38 provided by this section; or
8-39 (2) admissible in any civil, administrative, or
8-40 criminal proceeding.
8-41 (f) Notwithstanding Subsection (c)(1), the council may use
8-42 zip code information to analyze data on a geographic basis.
8-43 Sec. 108.014. CIVIL PENALTY. (a) A person who knowingly or
8-44 negligently releases data in violation of this chapter is liable
8-45 for a civil penalty of not more than $10,000.
8-46 (b) A person who fails to supply available data under
8-47 Sections 108.009 and 108.010 is liable for a civil penalty of not
8-48 less than $1,000 or more than $10,000 for each act of violation.
8-49 (c) The attorney general, at the request of the council,
8-50 shall enforce this chapter.
8-51 Sec. 108.015. CONFLICT OF INTEREST. The council may not
8-52 accept a donation from a person required to provide data under this
8-53 chapter or from a person or business entity who provides goods or
8-54 services to the council for compensation.
8-55 SECTION 2. Section 311.032(a), Health and Safety Code, is
8-56 amended to read as follows:
8-57 (a) The department shall establish a uniform reporting and
8-58 collection system for hospital financial and<,> utilization<, and
8-59 patient discharge> data.
8-60 SECTION 3. Section 311.035(c), Health and Safety Code, is
8-61 amended to read as follows:
8-62 (c) The department shall enter into an interagency agreement
8-63 with the Texas Department of Mental Health and Mental Retardation,
8-64 Texas Commission on Alcohol and Drug Abuse, and Texas Department of
8-65 Insurance relating to the mental health and chemical dependency
8-66 <hospital discharge> data collected under Section 311.0335. The
8-67 agreement shall address the collection, analysis, and sharing of
8-68 the data by the agencies.
8-69 SECTION 4. Subchapter C, Chapter 2054, Government Code, is
8-70 amended by adding Section 2054.0541 to read as follows:
9-1 Sec. 2054.0541. STATEWIDE HEALTH CARE DATA COLLECTION
9-2 SYSTEM. The department shall assist the Texas Health Care
9-3 Information Council and the Texas Department of Health with
9-4 planning, analyses, and management functions relating to the
9-5 procurement, use, and implementation of a statewide health care
9-6 data collection system under Chapter 108, Health and Safety Code.
9-7 SECTION 5. The following laws are repealed:
9-8 (1) Section 311.035(b), Health and Safety Code; and
9-9 (2) Section 311.034, Health and Safety Code.
9-10 SECTION 6. (a) The governor shall make appointments to the
9-11 Texas Health Care Information Council as soon as practicable after
9-12 the effective date of this Act.
9-13 (b) The governor shall make the initial appointments to the
9-14 Texas Health Care Information Council as follows:
9-15 (1) one representative of business, one representative
9-16 from labor, one representative of hospitals, one representative of
9-17 physicians, and one non-health-care professional member serve terms
9-18 expiring September 1, 1997;
9-19 (2) one representative of business, one consumer
9-20 representative, one representative of physicians, one
9-21 representative of hospitals, and the representative of a health
9-22 maintenance organization serve terms expiring September 1, 1999;
9-23 and
9-24 (3) one representative from labor, one representative
9-25 of business, one consumer representative, one representative of
9-26 physicians, and one non-health-care professional member serve terms
9-27 expiring September 1, 2001.
9-28 SECTION 7. Not later than December 1, 1996, the Texas Health
9-29 Care Information Council appointed under Chapter 108, Health and
9-30 Safety Code, as added by this Act, shall make recommendations under
9-31 Section 108.006(a)(5) of that code relating to consolidation of
9-32 health data collection programs existing on the effective date of
9-33 this Act, together with proposed legislation necessary to effect
9-34 any recommended consolidation.
9-35 SECTION 8. This Act takes effect September 1, 1995.
9-36 SECTION 9. The importance of this legislation and the
9-37 crowded condition of the calendars in both houses create an
9-38 emergency and an imperative public necessity that the
9-39 constitutional rule requiring bills to be read on three several
9-40 days in each house be suspended, and this rule is hereby suspended.
9-41 * * * * *