1-1 By: Madla S.B. No. 548
1-2 (In the Senate - Filed February 14, 1995; February 15, 1995,
1-3 read first time and referred to Committee on Health and Human
1-4 Services; April 5, 1995, reported favorably, as amended, by the
1-5 following vote: Yeas 5, Nays 0; April 5, 1995, sent to printer.)
1-6 COMMITTEE AMENDMENT NO. 1 By: Madla
1-7 Amend S.B. No. 548 as follows:
1-8 (1) On page 3, line 9 (committee printing page 2, line 12),
1-9 between "the" and "court" insert "information is relevant to the
1-10 proceeding and the"; and
1-11 (2) On page 8, lines 3-8 (committee printing page 4, lines
1-12 1-6), strike Article 4567 in its entirety and substitute the
1-13 following:
1-14 Art. 4576. PODIATRY SERVICES FOR CERTAIN HEALTH
1-15 ORGANIZATIONS. A licensed podiatrist may contract with a health
1-16 organization approved by the Texas State Board of Medical Examiners
1-17 under Section 5.01, Medical Practice Act (Article 4495b, Vernon's
1-18 Texas Civil Statutes) to provide podiatry services on its behalf.
1-19 A BILL TO BE ENTITLED
1-20 AN ACT
1-21 relating to the regulation of podiatry.
1-22 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-23 SECTION 1. Chapter 11, Title 71, Revised Statutes, is
1-24 amended by adding Article 4575d to read as follows:
1-25 Art. 4575d. CONFIDENTIALITY AND PRIVILEGE REQUIREMENTS
1-26 Sec. 1. In this article:
1-27 (1) "Patient" means a person who, to receive podiatric
1-28 care, consults or is seen by a person licensed to practice
1-29 podiatry.
1-30 (2) "Podiatric record" means any record relating to
1-31 the history, diagnosis, treatment, or prognosis of a patient.
1-32 Sec. 2. (a) A communication that relates to or is in
1-33 connection with professional services rendered as a podiatrist,
1-34 between a person who holds a license to practice podiatry and a
1-35 patient, is confidential and privileged and may not be disclosed
1-36 except as provided by this article.
1-37 (b) Records of the identity, diagnosis, evaluation, or
1-38 treatment of a patient by a podiatrist that are created or
1-39 maintained by a podiatrist are confidential and privileged and may
1-40 not be disclosed except as provided by this article.
1-41 (c) A person who receives information from confidential
1-42 communications or podiatric records, other than a person listed
1-43 under Section 5 or 6 of this article who is acting on the patient's
1-44 behalf, may not disclose the information except to the extent that
1-45 disclosure is consistent with the authorized purposes for which the
1-46 information was first obtained.
1-47 (d) The prohibitions of this section continue to apply to
1-48 confidential communications or records concerning a patient
1-49 irrespective of when the patient received the services of a
1-50 podiatrist.
1-51 Sec. 3. (a) The privilege of confidentiality under this
1-52 article may be claimed by the patient or by a podiatrist acting on
1-53 the patient's behalf.
1-54 (b) The podiatrist may claim the privilege of
1-55 confidentiality only on behalf of the patient. The authority to
1-56 claim the privilege is presumed in the absence of evidence to the
1-57 contrary.
1-58 Sec. 4. (a) An exception to the confidentiality and
1-59 privilege requirements under this article exists in a court or
1-60 administrative proceeding if:
1-61 (1) the proceeding is brought by the patient against a
1-62 podiatrist, including a malpractice proceeding or any criminal or
1-63 license revocation proceeding in which the patient is a complaining
1-64 witness and in which disclosure is relevant to the claims or
1-65 defense of a podiatrist;
1-66 (2) the patient or a person authorized to act on the
1-67 patient's behalf submits a written consent to the release of any
1-68 confidential information, as provided by Section 6 of this article;
2-1 or
2-2 (3) the purpose of the proceeding is to substantiate
2-3 and collect on a claim for podiatric services rendered to the
2-4 patient.
2-5 (b) An exception to the confidentiality and privilege
2-6 requirements under this article exists in a civil litigation or
2-7 administrative proceeding that is brought by the patient or another
2-8 person on the patient's behalf if the plaintiff is attempting to
2-9 recover monetary damages for any physical or mental condition,
2-10 including the death of the patient. Information is discoverable in
2-11 a court or administrative proceeding in this state if the court or
2-12 administrative body has jurisdiction over the subject matter under
2-13 the applicable rules of procedure specified for that matter.
2-14 (c) An exception to the confidentiality and privilege
2-15 requirements under this article exists in a disciplinary
2-16 investigation or proceeding against a podiatrist conducted under
2-17 this chapter. The board shall protect the identity of any patient
2-18 whose podiatric records are examined under this subsection, other
2-19 than those patients:
2-20 (1) covered under Subsection (a)(1) of this section;
2-21 or
2-22 (2) who have submitted written consent to the release
2-23 of their podiatric records as provided by Section 6 of this
2-24 article.
2-25 (d) An exception to the confidentiality and privilege
2-26 requirements under this article exists in a criminal investigation
2-27 of or criminal proceeding against a podiatrist in which the board
2-28 is participating or assisting by providing certain records obtained
2-29 from the podiatrist. The board shall protect the identity of any
2-30 patient whose records are provided in the investigation or
2-31 proceeding, other than patients covered under Subsection (a)(1) of
2-32 this section or who have submitted written consent to the release
2-33 of their podiatric records as provided by Section 6 of this
2-34 article. This subsection does not authorize the release of any
2-35 confidential information for the purpose of instigating or
2-36 substantiating criminal charges against a patient.
2-37 (e) An exception to the confidentiality or privilege
2-38 requirements under this article exists in a criminal prosecution in
2-39 which the patient is a victim, witness, or defendant. Records or
2-40 communications are not discoverable under this subsection until the
2-41 court in which the prosecution is pending makes an in camera
2-42 determination as to the relevancy of the records or communications
2-43 or any portion of the records or communications. That
2-44 determination does not constitute a determination as to the
2-45 admissibility of the records or communications or any portion of
2-46 the records or communications.
2-47 Sec. 5. (a) In circumstances other than those described by
2-48 Section 4, an exception to the confidentiality or privilege
2-49 requirements of this article exists only for, and a podiatrist may
2-50 disclose confidential information only to:
2-51 (1) a governmental agency, if:
2-52 (A) the disclosure is required or permitted by
2-53 law; and
2-54 (B) the agency protects the identity of any
2-55 patient whose podiatric records are examined;
2-56 (2) medical or law enforcement personnel, if the
2-57 podiatrist determines that there is a probability of:
2-58 (A) imminent physical injury to the patient, the
2-59 podiatrist, or others; or
2-60 (B) immediate mental or emotional injury to the
2-61 patient;
2-62 (3) qualified personnel for the purpose of management
2-63 audits, financial audits, program evaluations, or research;
2-64 (4) a person who presents the written consent of the
2-65 patient or another person authorized to act on the patient's behalf
2-66 for the release of confidential information, as provided by Section
2-67 6 of this article;
2-68 (5) an individual, corporation, or governmental entity
2-69 involved in the payment or collection of fees for services rendered
2-70 by a podiatrist; or
3-1 (6) another podiatrist and persons under the direction
3-2 of the podiatrist who are participating in the diagnosis,
3-3 evaluation, or treatment of the patient.
3-4 (b) A person who receives information under Subsection
3-5 (a)(3) of this section may not identify a patient, directly or
3-6 indirectly, in any report of the research, audit, or evaluation or
3-7 otherwise disclose a patient's identity.
3-8 (c) Records reflecting charges and specific services
3-9 rendered may be disclosed only when necessary in the collection of
3-10 fees for services provided by a podiatrist, professional
3-11 association, or other entity qualified to render or arrange for
3-12 services.
3-13 (d) Information otherwise confidential under this article
3-14 may be disclosed in an official legislative inquiry regarding a
3-15 state hospital or state school. However, information or records
3-16 that identify a patient or client may not be released for any
3-17 purpose unless proper consent to the release is given by the
3-18 patient. This subsection applies only to records created by the
3-19 state hospital, state school, or an employee of the state hospital
3-20 or state school.
3-21 Sec. 6. (a) Consent for the release of confidential
3-22 information must be made in writing and signed by:
3-23 (1) the patient;
3-24 (2) a parent or legal guardian if the patient is a
3-25 minor;
3-26 (3) a legal guardian if the patient has been
3-27 adjudicated incompetent to manage the patient's personal affairs;
3-28 (4) an attorney ad litem appointed for the patient, as
3-29 authorized by:
3-30 (A) the Texas Mental Health Code (Subtitle C,
3-31 Title 7, Health and Safety Code);
3-32 (B) the Persons with Mental Retardation Act
3-33 (Subtitle D, Title 7, Health and Safety Code);
3-34 (C) Subtitle B, Title 6, Health and Safety Code;
3-35 (D) Subtitle E, Title 7, Health and Safety Code;
3-36 (E) Chapter 5, Texas Probate Code;
3-37 (F) Chapter 11, Family Code; or
3-38 (G) another applicable law; or
3-39 (5) a personal representative if the patient is
3-40 deceased.
3-41 (b) The written consent required under this section must
3-42 specify:
3-43 (1) the information and records to be covered by the
3-44 release;
3-45 (2) the reasons or purposes for the release; and
3-46 (3) the person to whom the information is to be
3-47 released.
3-48 (c) The patient or other person authorized to consent has
3-49 the right to withdraw the consent to the release of any
3-50 information. Withdrawal of consent does not affect information
3-51 disclosed before the written notice of the withdrawal.
3-52 Sec. 7. A person who receives information made confidential
3-53 by this article may disclose the information to others only to the
3-54 extent consistent with the authorized purposes for which consent to
3-55 release the information was obtained.
3-56 Sec. 8. (a) A podiatrist shall furnish copies of podiatric
3-57 records requested or a summary or narrative of the records under a
3-58 written consent for release of the information as provided by
3-59 Section 6 of this article unless the podiatrist determines that
3-60 access to the information would be harmful to the physical, mental,
3-61 or emotional health of the patient. The podiatrist may delete
3-62 confidential information about another person who has not consented
3-63 to the release.
3-64 (b) The information shall be furnished by the podiatrist
3-65 within a reasonable period of time, and reasonable fees for
3-66 furnishing the information shall be paid by the patient or another
3-67 person acting on the patient's behalf.
3-68 SECTION 2. Chapter 11, Title 71, Revised Statutes, is
3-69 amended by adding Article 4576 to read as follows:
3-70 Art. 4576. PODIATRY SERVICES FOR CERTAIN HEALTH
4-1 ORGANIZATIONS. A licensed podiatrist may participate in and
4-2 provide podiatry services on behalf of any health organization
4-3 approved by the Texas State Board of Medical Examiners under
4-4 Section 5.01, Medical Practice Act (Article 4495b, Vernon's Texas
4-5 Civil Statutes).
4-6 SECTION 3. Article 4575d, Revised Statutes, as added by this
4-7 Act, applies only to podiatric records and information disclosed on
4-8 or after the effective date of this Act. Records and information
4-9 disclosed before that date are governed by the law in effect on the
4-10 date that the record or information is disclosed, and the former
4-11 law is continued in effect for that purpose.
4-12 SECTION 4. This Act takes effect September 1, 1995.
4-13 SECTION 5. The importance of this legislation and the
4-14 crowded condition of the calendars in both houses create an
4-15 emergency and an imperative public necessity that the
4-16 constitutional rule requiring bills to be read on three several
4-17 days in each house be suspended, and this rule is hereby suspended.
4-18 * * * * *