By Madla S.B. No. 548
74R2259 PB-F
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the regulation of podiatry.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Chapter 11, Title 71, Revised Statutes, is
1-5 amended by adding Article 4575d to read as follows:
1-6 Art. 4575d. CONFIDENTIALITY AND PRIVILEGE REQUIREMENTS
1-7 Sec. 1. In this article:
1-8 (1) "Patient" means a person who, to receive podiatric
1-9 care, consults or is seen by a person licensed to practice
1-10 podiatry.
1-11 (2) "Podiatric record" means any record relating to
1-12 the history, diagnosis, treatment, or prognosis of a patient.
1-13 Sec. 2. (a) A communication that relates to or is in
1-14 connection with professional services rendered as a podiatrist,
1-15 between a person who holds a license to practice podiatry and a
1-16 patient, is confidential and privileged and may not be disclosed
1-17 except as provided by this article.
1-18 (b) Records of the identity, diagnosis, evaluation, or
1-19 treatment of a patient by a podiatrist that are created or
1-20 maintained by a podiatrist are confidential and privileged and may
1-21 not be disclosed except as provided by this article.
1-22 (c) A person who receives information from confidential
1-23 communications or podiatric records, other than a person listed
1-24 under Section 5 or 6 of this article who is acting on the patient's
2-1 behalf, may not disclose the information except to the extent that
2-2 disclosure is consistent with the authorized purposes for which the
2-3 information was first obtained.
2-4 (d) The prohibitions of this section continue to apply to
2-5 confidential communications or records concerning a patient
2-6 irrespective of when the patient received the services of a
2-7 podiatrist.
2-8 Sec. 3. (a) The privilege of confidentiality under this
2-9 article may be claimed by the patient or by a podiatrist acting on
2-10 the patient's behalf.
2-11 (b) The podiatrist may claim the privilege of
2-12 confidentiality only on behalf of the patient. The authority to
2-13 claim the privilege is presumed in the absence of evidence to the
2-14 contrary.
2-15 Sec. 4. (a) An exception to the confidentiality and
2-16 privilege requirements under this article exists in a court or
2-17 administrative proceeding if:
2-18 (1) the proceeding is brought by the patient against a
2-19 podiatrist, including a malpractice proceeding or any criminal or
2-20 license revocation proceeding in which the patient is a complaining
2-21 witness and in which disclosure is relevant to the claims or
2-22 defense of a podiatrist;
2-23 (2) the patient or a person authorized to act on the
2-24 patient's behalf submits a written consent to the release of any
2-25 confidential information, as provided by Section 6 of this article;
2-26 or
2-27 (3) the purpose of the proceeding is to substantiate
3-1 and collect on a claim for podiatric services rendered to the
3-2 patient.
3-3 (b) An exception to the confidentiality and privilege
3-4 requirements under this article exists in a civil litigation or
3-5 administrative proceeding that is brought by the patient or another
3-6 person on the patient's behalf if the plaintiff is attempting to
3-7 recover monetary damages for any physical or mental condition,
3-8 including the death of the patient. Information is discoverable in
3-9 a court or administrative proceeding in this state if the court or
3-10 administrative body has jurisdiction over the subject matter under
3-11 the applicable rules of procedure specified for that matter.
3-12 (c) An exception to the confidentiality and privilege
3-13 requirements under this article exists in a disciplinary
3-14 investigation or proceeding against a podiatrist conducted under
3-15 this chapter. The board shall protect the identity of any patient
3-16 whose podiatric records are examined under this subsection, other
3-17 than those patients:
3-18 (1) covered under Subsection (a)(1) of this section;
3-19 or
3-20 (2) who have submitted written consent to the release
3-21 of their podiatric records as provided by Section 6 of this
3-22 article.
3-23 (d) An exception to the confidentiality and privilege
3-24 requirements under this article exists in a criminal investigation
3-25 of, or criminal proceeding against, a podiatrist in which the board
3-26 is participating or assisting by providing certain records obtained
3-27 from the podiatrist. The board shall protect the identity of any
4-1 patient whose records are provided in the investigation or
4-2 proceeding, other than patients covered under Subsection (a)(1) of
4-3 this section or who have submitted written consent to the release
4-4 of their podiatric records as provided by Section 6 of this
4-5 article. This subsection does not authorize the release of any
4-6 confidential information for the purpose of instigating or
4-7 substantiating criminal charges against a patient.
4-8 (e) An exception to the confidentiality or privilege
4-9 requirements under this article exists in a criminal prosecution in
4-10 which the patient is a victim, witness, or defendant. Records or
4-11 communications are not discoverable under this subsection until the
4-12 court in which the prosecution is pending makes an in camera
4-13 determination as to the relevancy of the records or communications
4-14 or any portion of the records or communications. That
4-15 determination does not constitute a determination as to the
4-16 admissibility of the records or communications or any portion of
4-17 the records or communications.
4-18 Sec. 5. (a) In circumstances other than those described by
4-19 Section 4, an exception to the confidentiality or privilege
4-20 requirements of this article exists only for, and a podiatrist may
4-21 disclose confidential information only to:
4-22 (1) a governmental agency, if:
4-23 (A) the disclosure is required or permitted by
4-24 law; and
4-25 (B) the agency protects the identity of any
4-26 patient whose podiatric records are examined;
4-27 (2) medical or law enforcement personnel, if the
5-1 podiatrist determines that there is a probability of:
5-2 (A) imminent physical injury to the patient, the
5-3 podiatrist, or others; or
5-4 (B) immediate mental or emotional injury to the
5-5 patient;
5-6 (3) qualified personnel for the purpose of management
5-7 audits, financial audits, program evaluations, or research;
5-8 (4) a person who presents the written consent of the
5-9 patient or another person authorized to act on the patient's behalf
5-10 for the release of confidential information, as provided by Section
5-11 6 of this article;
5-12 (5) an individual, corporation, or governmental entity
5-13 involved in the payment or collection of fees for services rendered
5-14 by a podiatrist; or
5-15 (6) another podiatrist and persons under the direction
5-16 of the podiatrist who are participating in the diagnosis,
5-17 evaluation, or treatment of the patient.
5-18 (b) A person who receives information under Subsection
5-19 (a)(3) of this section may not identify a patient, directly or
5-20 indirectly, in any report of the research, audit, or evaluation or
5-21 otherwise disclose a patient's identity.
5-22 (c) Records reflecting charges and specific services
5-23 rendered may be disclosed only when necessary in the collection of
5-24 fees for services provided by a podiatrist, professional
5-25 association, or other entity qualified to render or arrange for
5-26 services.
5-27 (d) Information otherwise confidential under this article
6-1 may be disclosed in an official legislative inquiry regarding a
6-2 state hospital or state school. However, information or records
6-3 that identify a patient or client may not be released for any
6-4 purpose unless proper consent to the release is given by the
6-5 patient. This subsection applies only to records created by the
6-6 state hospital, state school, or an employee of the state hospital
6-7 or state school.
6-8 Sec. 6. (a) Consent for the release of confidential
6-9 information must be made in writing and signed by:
6-10 (1) the patient;
6-11 (2) a parent or legal guardian if the patient is a
6-12 minor;
6-13 (3) a legal guardian if the patient has been
6-14 adjudicated incompetent to manage the patient's personal affairs;
6-15 (4) an attorney ad litem appointed for the patient, as
6-16 authorized by:
6-17 (A) the Texas Mental Health Code (Subtitle C,
6-18 Title 7, Health and Safety Code);
6-19 (B) the Persons with Mental Retardation Act
6-20 (Subtitle D, Title 7, Health and Safety Code);
6-21 (C) Subtitle B, Title 6, Health and Safety Code;
6-22 (D) Subtitle E, Title 7, Health and Safety Code;
6-23 (E) Chapter 5, Texas Probate Code;
6-24 (F) Chapter 11, Family Code; or
6-25 (G) another applicable law; or
6-26 (5) a personal representative if the patient is
6-27 deceased.
7-1 (b) The written consent required under this section must
7-2 specify:
7-3 (1) the information and records to be covered by the
7-4 release;
7-5 (2) the reasons or purposes for the release; and
7-6 (3) the person to whom the information is to be
7-7 released.
7-8 (c) The patient or other person authorized to consent has
7-9 the right to withdraw the consent to the release of any
7-10 information. Withdrawal of consent does not affect information
7-11 disclosed before the written notice of the withdrawal.
7-12 Sec. 7. A person who receives information made confidential
7-13 by this article may disclose the information to others only to the
7-14 extent consistent with the authorized purposes for which consent to
7-15 release the information was obtained.
7-16 Sec. 8. (a) A podiatrist shall furnish copies of podiatric
7-17 records requested or a summary or narrative of the records under a
7-18 written consent for release of the information as provided by
7-19 Section 6 of this article unless the podiatrist determines that
7-20 access to the information would be harmful to the physical, mental,
7-21 or emotional health of the patient. The podiatrist may delete
7-22 confidential information about another person who has not consented
7-23 to the release.
7-24 (b) The information shall be furnished by the podiatrist
7-25 within a reasonable period of time, and reasonable fees for
7-26 furnishing the information shall be paid by the patient or another
7-27 person acting on the patient's behalf.
8-1 SECTION 2. Chapter 11, Title 71, Revised Statutes, is
8-2 amended by adding Article 4576 to read as follows:
8-3 Art. 4576. PODIATRY SERVICES FOR CERTAIN HEALTH
8-4 ORGANIZATIONS. A licensed podiatrist may participate in and
8-5 provide podiatry services on behalf of any health organization
8-6 approved by the Texas State Board of Medical Examiners under
8-7 Section 5.01, Medical Practice Act (Article 4495b, Vernon's Texas
8-8 Civil Statutes).
8-9 SECTION 3. Article 4575d, Revised Statutes, as added by this
8-10 Act, applies only to podiatric records and information disclosed on
8-11 or after the effective date of this Act. Records and information
8-12 disclosed before that date are governed by the law in effect on the
8-13 date that the record or information is disclosed, and the former
8-14 law is continued in effect for that purpose.
8-15 SECTION 4. This Act takes effect September 1, 1995.
8-16 SECTION 5. The importance of this legislation and the
8-17 crowded condition of the calendars in both houses create an
8-18 emergency and an imperative public necessity that the
8-19 constitutional rule requiring bills to be read on three several
8-20 days in each house be suspended, and this rule is hereby suspended.