1-1  By:  Madla                                             S.B. No. 667
    1-2        (In the Senate - Filed February 20, 1995; February 21, 1995,
    1-3  read first time and referred to Committee on Health and Human
    1-4  Services; April 27, 1995, reported adversely, with favorable
    1-5  Committee Substitute by the following vote:  Yeas 7, Nays 0;
    1-6  April 27, 1995, sent to printer.)
    1-7  COMMITTEE SUBSTITUTE FOR S.B. No. 667                    By:  Madla
    1-8                         A BILL TO BE ENTITLED
    1-9                                AN ACT
   1-10  relating to the disclosure of health and mental health care
   1-11  information by certain providers of health care or mental health
   1-12  care.
   1-13        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
   1-14        SECTION 1.  Chapter 241, Health and Safety Code, is amended
   1-15  by adding Subchapter G to read as follows:
   1-16         SUBCHAPTER G.  DISCLOSURE OF HEALTH CARE INFORMATION
   1-17        Sec. 241.151.  DEFINITIONS.  In this subchapter:
   1-18              (1)  "Health care information" means information
   1-19  recorded in any form or medium that identifies a patient and
   1-20  relates to the history, diagnosis, treatment, or prognosis of a
   1-21  patient.
   1-22              (2)  "Health care provider" means a person who is
   1-23  licensed, certified, or otherwise authorized by the laws of this
   1-24  state to provide health care in the ordinary course of business or
   1-25  practice of a profession.
   1-26              (3)  "Institutional review board" means a board,
   1-27  committee, or other group formally designated by an institution or
   1-28  authorized under federal or state law to review or approve the
   1-29  initiation of or conduct periodic review of research programs to
   1-30  ensure the protection of the rights and welfare of human research
   1-31  subjects.
   1-32              (4)  "Legally authorized representative" means a parent
   1-33  or legal guardian if the patient is a minor, a legal guardian if
   1-34  the patient has been adjudicated incompetent to manage the
   1-35  patient's personal affairs, an agent of the patient authorized
   1-36  under a durable power of attorney for health care, an attorney ad
   1-37  litem appointed for the patient, a personal representative or
   1-38  statutory beneficiary if the patient is deceased, or an attorney
   1-39  retained by the patient or by the patient's legally authorized
   1-40  representative.
   1-41        Sec. 241.152.  WRITTEN AUTHORIZATION FOR DISCLOSURE OF HEALTH
   1-42  CARE INFORMATION.  (a)  Except as authorized by Section 241.153, a
   1-43  hospital or an agent or employee of a hospital may not disclose
   1-44  health care information about a patient to any person other than
   1-45  the patient without the written authorization of the patient or the
   1-46  patient's legally authorized representative.
   1-47        (b)  A disclosure authorization to a hospital is valid only
   1-48  if it:
   1-49              (1)  is in writing;
   1-50              (2)  is dated and signed by the patient or the
   1-51  patient's legally authorized representative;
   1-52              (3)  identifies the information to be disclosed; and
   1-53              (4)  identifies the person or entity to whom the
   1-54  information is to be disclosed.
   1-55        (c)  A disclosure authorization is valid until the 90th day
   1-56  after the date it is signed unless it provides otherwise or unless
   1-57  it is revoked.
   1-58        (d)  Except as provided by Subsection (e), a patient or the
   1-59  patient's legally authorized representative may revoke a disclosure
   1-60  authorization to a hospital at any time.  A revocation is valid
   1-61  only if it is in writing, dated with a date that is later than the
   1-62  date on the original authorization, and signed by the patient or
   1-63  the patient's legally authorized representative.
   1-64        (e)  A patient or the patient's legally authorized
   1-65  representative may not revoke a disclosure that is required for
   1-66  purposes of making payment to the hospital for health care provided
   1-67  to the patient.
   1-68        (f)  A patient may not maintain an action against a hospital
    2-1  for a disclosure made by the hospital in good-faith reliance on an
    2-2  authorization if the hospital's medical record department did not
    2-3  have notice that the authorization was revoked.
    2-4        (g)  A hospital may not charge a fee for providing health
    2-5  care information under Section 241.154(b) to the extent the fee is
    2-6  prohibited under Subchapter M, Chapter 161.
    2-7        Sec. 241.153.  DISCLOSURE WITHOUT WRITTEN AUTHORIZATION.  A
    2-8  patient's health care information may be disclosed without the
    2-9  patient's authorization if the disclosure is:
   2-10              (1)  to a health care provider who is rendering health
   2-11  care to the patient when the request for the disclosure is made;
   2-12              (2)  to an employee or agent of the hospital who
   2-13  requires health care information for health care education, quality
   2-14  assurance, or peer review or for assisting the hospital in the
   2-15  delivery of health care or in complying with statutory, licensing,
   2-16  accreditation, or certification requirements and if the hospital
   2-17  takes appropriate action to ensure that the employee or agent:
   2-18                    (A)  will not use or disclose the health care
   2-19  information for any other purpose; and
   2-20                    (B)  will take appropriate steps to protect the
   2-21  health care information;
   2-22              (3)  to a federal, state, or local government agency or
   2-23  authority to the extent authorized or required by law;
   2-24              (4)  to a hospital that is the successor in interest to
   2-25  the hospital maintaining the health care information;
   2-26              (5)  for use in a research project authorized by an
   2-27  institutional review board under federal law;
   2-28              (6)  to health care personnel of a penal or other
   2-29  custodial institution in which the patient is detained if the
   2-30  disclosure is for the sole purpose of providing health care to the
   2-31  patient;
   2-32              (7)  to facilitate reimbursement by a health benefit
   2-33  plan to a hospital, other health care provider, or the patient for
   2-34  medical services or supplies;
   2-35              (8)  to a health maintenance organization for purposes
   2-36  of maintaining a statistical reporting system as required by a rule
   2-37  adopted by a state agency or regulations adopted under the federal
   2-38  Health Maintenance Organization Act of 1973, as amended (42 U.S.C.
   2-39  Section 300 et seq.);
   2-40              (9)  to satisfy a request for medical records of a
   2-41  deceased or incompetent person pursuant to Section 4.01(e), Medical
   2-42  Liability and Insurance Improvement Act of Texas (Article 4590i,
   2-43  Vernon's Texas Civil Statutes); or
   2-44              (10)  to a court pursuant to a court order or court
   2-45  subpoena.
   2-46        Sec. 241.154.  AUTHORIZED REQUEST.  (a)  On receipt of a
   2-47  written authorization from a patient or legally authorized
   2-48  representative to examine or copy all or part of the patient's
   2-49  recorded health care information, a hospital, as promptly as
   2-50  required under the circumstances but not later than the 15th day
   2-51  after the date the request is received, shall:
   2-52              (1)  make the information available for examination
   2-53  during regular business hours and provide a copy to the authorized
   2-54  requestor, if requested; or
   2-55              (2)  inform the authorized requestor if the information
   2-56  does not exist or cannot be found.
   2-57        (b)  The hospital may charge a reasonable fee for providing
   2-58  the health care information and is not required to permit
   2-59  examination or copying until the fee is paid unless there is a
   2-60  medical emergency.  The fee may not exceed the sum of:
   2-61              (1)  a retrieval or processing fee, which must include
   2-62  the fee for providing the first 10 pages of the copies and which
   2-63  may not exceed $30; and
   2-64                    (A)  a charge for each page of:
   2-65                          (i)  $1 for the 11th through the 60th page
   2-66  of the provided copies;
   2-67                          (ii)  50 cents for the 61st through the
   2-68  400th page of the provided copies; and
   2-69                          (iii)  25 cents for any remaining pages of
   2-70  the provided copies; and
    3-1                    (B)  the actual cost of mailing, shipping, or
    3-2  otherwise delivering the provided copies; or
    3-3              (2)  if the requested records are stored on microfiche,
    3-4  a retrieval or processing fee, which must include the fee for
    3-5  providing the first 10 pages of the copies and which may not exceed
    3-6  $45; and
    3-7                    (A)  $1 per page thereafter; and
    3-8                    (B)  the actual cost of mailing, shipping, or
    3-9  otherwise delivering the provided copies.
   3-10        (c)  Effective September 1, 1996, and annually thereafter,
   3-11  the fee for providing health care information as specified in this
   3-12  section shall be adjusted accordingly based on the most recent
   3-13  changes to the consumer price index as published by the Bureau of
   3-14  Labor Statistics of the United States Department of Labor that
   3-15  measures the average changes in prices of goods and services
   3-16  purchased by urban wage earners and clerical workers' families and
   3-17  single workers living alone.
   3-18        Sec. 241.155.  SAFEGUARDS FOR SECURITY OF HEALTH CARE
   3-19  INFORMATION.  A hospital shall adopt and implement reasonable
   3-20  safeguards for the security of all health care information it
   3-21  maintains.
   3-22        Sec. 241.156.  PATIENT REMEDIES.  (a)  A patient aggrieved by
   3-23  a violation of this subchapter relating to the unauthorized release
   3-24  of confidential health care information may bring an action for:
   3-25              (1)  appropriate injunctive relief; and
   3-26              (2)  damages resulting from the release.
   3-27        (b)  An action under Subsection (a) shall be brought in:
   3-28              (1)  the district court of the county in which the
   3-29  patient resides or in the case of a deceased patient the district
   3-30  court of the county in which the patient's legally authorized
   3-31  representative resides; or
   3-32              (2)  if the patient or the patient's legally authorized
   3-33  representative in the case of a deceased patient is not a resident
   3-34  of this state, the district court of Travis County.
   3-35        (c)  A petition for injunctive relief under Subsection (a)(1)
   3-36  takes precedence over all civil matters on the court docket except
   3-37  those matters to which equal precedence on the docket is granted by
   3-38  law.
   3-39        SECTION 2.  Subsection (a), Section 1.03, Medical Practice
   3-40  Act (Article 4495b, Vernon's Texas Civil Statutes), is amended by
   3-41  adding Subdivisions (17) and (18) to read as follows:
   3-42              (17)  "Legally authorized representative" means a
   3-43  parent or legal guardian if the patient is a minor, a legal
   3-44  guardian if the patient has been adjudicated incompetent to manage
   3-45  the patient's personal affairs, an agent of the patient authorized
   3-46  under a durable power of attorney for health care, an attorney ad
   3-47  litem appointed for the patient, a personal representative or
   3-48  statutory beneficiary if the patient is deceased, or an attorney
   3-49  retained by the patient or by the patient's legally authorized
   3-50  representative.
   3-51              (18)  "Medical records" means all records pertaining to
   3-52  the history, diagnosis, treatment, or prognosis of a patient.
   3-53        SECTION 3.  Subsections (g) and (h), Section 5.08, Medical
   3-54  Practice Act (Article 4495b, Vernon's Texas Civil Statutes), are
   3-55  amended to read as follows:
   3-56        (g)  Exceptions to confidentiality or privilege in court or
   3-57  administrative proceedings exist:
   3-58              (1)  when the proceedings are brought by the patient
   3-59  against a physician, including but not limited to malpractice
   3-60  proceedings, and any criminal or license revocation proceeding in
   3-61  which the patient is a complaining witness and in which disclosure
   3-62  is relevant to the claims or defense of a physician;
   3-63              (2)  when the patient or someone authorized to act on
   3-64  his behalf submits a written consent to the release of any
   3-65  confidential information, as provided in Subsection (j) of this
   3-66  section;
   3-67              (3)  when the purpose of the proceedings is to
   3-68  substantiate and collect on a claim for medical services rendered
   3-69  to the patient;
   3-70              (4)  in any civil litigation or administrative
    4-1  proceeding, if relevant, brought by the patient or someone on his
    4-2  behalf if the patient is attempting to recover monetary damages for
    4-3  any physical or mental condition including death of the patient.
    4-4  Any information is discoverable in any court or administrative
    4-5  proceeding in this state if the court or administrative body has
    4-6  jurisdiction over the subject matter, pursuant to rules of
    4-7  procedure specified for the matters;
    4-8              (5)  in any disciplinary investigation or proceeding of
    4-9  a physician conducted under or pursuant to this Act, provided that
   4-10  the board shall protect the identity of any patient whose medical
   4-11  records are examined, except for those patients covered under
   4-12  Subdivision (1) of Subsection (g) of this section or those patients
   4-13  who have submitted written consent to the release of their medical
   4-14  records as provided by Subsection (j) of this section;
   4-15              (6)  in any criminal investigation of a physician in
   4-16  which the board is participating or assisting in the investigation
   4-17  or proceeding by providing certain medical records obtained from
   4-18  the physician, provided that the board shall protect the identity
   4-19  of any patient whose medical records are provided in the
   4-20  investigation or proceeding, except for those patients covered
   4-21  under Subdivision (1) of Subsection (g) of this section or those
   4-22  patients who have submitted written consent to the release of their
   4-23  medical records as provided by Subsection (j) of this section.
   4-24  This subsection does not authorize the release of any confidential
   4-25  information for the purpose of instigating or substantiating
   4-26  criminal charges against a patient;
   4-27              (7)  in an involuntary civil commitment proceeding,
   4-28  proceeding for court-ordered treatment, or probable cause hearing
   4-29  under:
   4-30                    (A)  Chapter 574, Health and Safety Code <the
   4-31  Texas Mental Health Code (Article 5547-1 et seq., Vernon's Texas
   4-32  Civil Statutes)>;
   4-33                    (B)  Chapter 593, Health and Safety Code <the
   4-34  Mentally Retarded Persons Act of 1977 (Article 5547-300, Vernon's
   4-35  Texas Civil Statutes)>; or
   4-36                    (C)  Chapter 462, Health and Safety Code <Section
   4-37  9, Chapter 411, Acts of the 53rd Legislature, Regular Session, 1953
   4-38  (Article 5561c, Vernon's Texas Civil Statutes)>;
   4-39                    <(D)  Section 2, Chapter 543, Acts of the 61st
   4-40  Legislature, Regular Session, 1969 (Article 5561c-1, Vernon's Texas
   4-41  Civil Statutes); or>
   4-42              (8)  when the patient's physical or mental condition is
   4-43  relevant to the execution of a will;
   4-44              (9)  when the information is relevant to a proceeding
   4-45  brought under Subsection (1) of this section;
   4-46              (10)  in any criminal prosecution where the patient is
   4-47  a victim, witness, or defendant.  Records are not discoverable
   4-48  until the court in which the prosecution is pending makes an in
   4-49  camera determination as to the relevancy of the records or
   4-50  communications or any portion thereof.  Such determination shall
   4-51  not constitute a determination as to the admissibility of such
   4-52  records or communications or any portion thereof;
   4-53              (11)  to satisfy a request for medical records of a
   4-54  deceased or incompetent person pursuant to Section 4.01(e), Medical
   4-55  Liability and Insurance Improvement Act of Texas (Article 4590i,
   4-56  Vernon's Texas Civil Statutes; or
   4-57              (12)  to a court or a party to an action pursuant to a
   4-58  court order or court subpoena.
   4-59        (h)  Exceptions to the privilege of confidentiality, in other
   4-60  than court or administrative proceedings, allowing disclosure of
   4-61  confidential information by a physician, exist only to the
   4-62  following:
   4-63              (1)  governmental agencies if the disclosures are
   4-64  required or authorized by law;
   4-65              (2)  medical or law enforcement personnel if the
   4-66  physician determines that there is a probability of imminent
   4-67  physical injury to the patient, to himself, or to others, or if
   4-68  there is a probability of immediate mental or emotional injury to
   4-69  the patient;
   4-70              (3)  qualified personnel for the purpose of management
    5-1  audits, financial audits, program evaluations, or research, but the
    5-2  personnel may not identify, directly or indirectly, a patient in
    5-3  any report of the research, audit, or evaluation or otherwise
    5-4  disclose identity in any manner;
    5-5              (4)  those parts of the medical records reflecting
    5-6  charges and specific services rendered when necessary in the
    5-7  collection of fees for medical services provided by a physician or
    5-8  physicians or professional associations or other entities qualified
    5-9  to render or arrange for medical services;
   5-10              (5)  any person who bears a written consent of the
   5-11  patient or other person authorized to act on the patient's behalf
   5-12  for the release of confidential information, as provided by
   5-13  Subsection (j) of this section;
   5-14              (6)  individuals, corporations, or governmental
   5-15  agencies involved in the payment or collection of fees for medical
   5-16  services rendered by a physician;
   5-17              (7)  other physicians and personnel under the direction
   5-18  of the physician who are participating in the diagnosis,
   5-19  evaluation, or treatment of the patient; <or>
   5-20              (8)  in any official legislative inquiry regarding
   5-21  state hospitals or state schools, provided that no information or
   5-22  records which identify a patient or client shall be released for
   5-23  any purpose unless proper consent to the release is given by the
   5-24  patient, and only records created by the state hospital or school
   5-25  or its employees shall be included under this subsection; or
   5-26              (9)  to health care personnel or a penal or other
   5-27  custodial institution in which the patient is detained if the
   5-28  disclosure is for the sole purpose of providing health care to the
   5-29  patient.
   5-30        SECTION 4.  Subdivision (2), Subsection (j), Section 5.08,
   5-31  Medical Practice Act (Article 4495b, Vernon's Texas Civil
   5-32  Statutes), is amended to read as follows:
   5-33              (2)  The patient, or other person authorized to
   5-34  consent, has the right to withdraw his consent to the release of
   5-35  any information.  Withdrawal of consent does not affect any
   5-36  information disclosed prior to the written notice of the
   5-37  withdrawal.  A patient may not maintain an action against a
   5-38  physician for a disclosure made by the physician in good faith
   5-39  reliance on a authorization if the physician did not have written
   5-40  notice that the authorization was revoked.
   5-41        SECTION 5.  Subsection (k), Section 5.08, Medical Practice
   5-42  Act (Article 4495b, Vernon's Texas Civil Statutes), is amended to
   5-43  read as follows:
   5-44        (k)  A physician shall furnish copies of medical records
   5-45  requested, or a summary or narrative of the records, including
   5-46  records received from a physician or other health care provider
   5-47  involved in the care or treatment of the patient, pursuant to a
   5-48  written consent for release of the information as provided by
   5-49  Subsection (j) of this section, except if the physician determines
   5-50  that access to the information would be harmful to the physical,
   5-51  mental, or emotional health of the patient, and the physician may
   5-52  delete confidential information about another patient or family
   5-53  member of the patient <person> who has not consented to the
   5-54  release.  The information shall be furnished by the physician
   5-55  within 30 days after the date of receipt of the request <and
   5-56  reasonable fees for furnishing the information shall be paid by the
   5-57  patient or someone on his behalf>.  If the physician denies the
   5-58  request, in whole or in part, the physician shall furnish the
   5-59  patient a written statement, signed and dated, stating the reason
   5-60  for the denial.  A copy of the statement denying the request shall
   5-61  be placed in the patient's medical records.  <In this subsection,
   5-62  "medical records" means any records pertaining to the history,
   5-63  diagnosis, treatment, or prognosis of the patient.>
   5-64        SECTION 6.  Section 5.08, Medical Practice Act (Article
   5-65  4495b, Vernon's Texas Civil Statutes), is amended by adding
   5-66  Subsections (o) and (p) to read as follows:
   5-67        (o)  The physician may charge a reasonable fee for copying
   5-68  medical records and is not required to permit examination or
   5-69  copying until the fee is paid unless there is a medical emergency.
   5-70  The board by rule shall prescribe what constitutes reasonable fees
    6-1  for purposes of this subsection.
    6-2        (p)  A physician may not charge a fee for copying medical
    6-3  records under Subsection (o) of this section to the extent the fee
    6-4  is prohibited under Subchapter M, Chapter 161, Health and Safety
    6-5  Code.
    6-6        SECTION 7.  Section 611.004, Health and Safety Code, is
    6-7  amended to read as follows:
    6-8        Sec. 611.004.  Authorized Disclosure of Confidential
    6-9  Information OTHER THAN IN JUDICIAL OR ADMINISTRATIVE PROCEEDING.
   6-10  (a)  A professional may disclose confidential information only:
   6-11              (1)  to a governmental agency if the disclosure is
   6-12  required or authorized by law;
   6-13              (2)  to medical or law enforcement personnel if the
   6-14  professional determines that there is a probability of imminent
   6-15  physical injury by the patient to the patient or others or there is
   6-16  a probability of immediate mental or emotional injury to the
   6-17  patient;
   6-18              (3)  to qualified personnel for management audits,
   6-19  financial audits, program evaluations, or research, in accordance
   6-20  with Subsection (b);
   6-21              (4)  to a person who has the written consent of the
   6-22  patient, or a parent if the patient is a minor, or a guardian if
   6-23  the patient has been adjudicated as incompetent to manage the
   6-24  patient's personal affairs;
   6-25              (5)  to the patient's personal representative if the
   6-26  patient is deceased;
   6-27              (6)  to individuals, corporations, or governmental
   6-28  agencies involved in paying or collecting fees for mental or
   6-29  emotional health services provided by a professional;
   6-30              (7)  to other professionals and personnel under the
   6-31  professionals' direction who participate in the diagnosis,
   6-32  evaluation, or treatment of the patient;
   6-33              (8)  in an official legislative inquiry relating to a
   6-34  state hospital or state school as provided by Subsection (c); <or>
   6-35              (9)  to health care personnel of a penal or other
   6-36  custodial institution in which the patient is detained if the
   6-37  disclosure is for the sole purpose of providing health care to the
   6-38  patient;
   6-39              (10)  to an employee or agent of the professional who
   6-40  requires mental health care information to provide mental health
   6-41  care services or in complying with statutory, licensing, or
   6-42  accreditation requirements, if the professional has taken
   6-43  appropriate action to ensure that the employee or agent:
   6-44                    (A)  will not use or disclose the information for
   6-45  any other purposes; and
   6-46                    (B)  will take appropriate steps to protect the
   6-47  information; or
   6-48              (11)  to satisfy a request for medical records of a
   6-49  deceased or incompetent person pursuant to Section 4.01(e), Medical
   6-50  Liability and Insurance Improvement Act of Texas (Article 4590i,
   6-51  Vernon's Texas Civil Statutes) <in a civil action or in a criminal
   6-52  case or criminal law matter as otherwise allowed by law or rule>.
   6-53        (b)  Personnel who receive confidential information under
   6-54  Subsection (a)(3) may not directly or indirectly identify or
   6-55  otherwise disclose the identity of a patient in a report or in any
   6-56  other manner.
   6-57        (c)  The exception in Subsection (a)(8) applies only to
   6-58  records created by the state hospital or state school or by the
   6-59  employees of the hospital or school.  Information or records that
   6-60  identify a patient may be released only with the patient's proper
   6-61  consent.
   6-62        (d)  A person who receives information from confidential
   6-63  communications or records may not disclose the information except
   6-64  to the extent that disclosure is consistent with the authorized
   6-65  purposes for which the person first obtained the information.  This
   6-66  subsection does not apply to a person listed in Subsection (a)(4)
   6-67  or (a)(5) who is acting on the patient's behalf.
   6-68        SECTION 8.  Chapter 611, Health and Safety Code, is amended
   6-69  by adding Sections 611.006, 611.007, and 611.008 to read as
   6-70  follows:
    7-1        Sec. 611.006.  AUTHORIZED DISCLOSURE OF CONFIDENTIAL
    7-2  INFORMATION IN JUDICIAL OR ADMINISTRATIVE PROCEEDING.  (a)  A
    7-3  professional may disclose confidential information in:
    7-4              (1)  a judicial or administrative proceeding brought by
    7-5  the patient or the patient's legally authorized representative
    7-6  against a professional, including malpractice proceedings;
    7-7              (2)  a license revocation proceeding in which the
    7-8  patient is a complaining witness and in which disclosure is
    7-9  relevant to the claim or defense of a professional;
   7-10              (3)  a judicial or administrative proceeding in which
   7-11  the patient waives the patient's right in writing to the privilege
   7-12  of confidentiality of information, or when a representative of the
   7-13  patient acting on the patient's behalf submits a written waiver to
   7-14  the confidentiality privilege;
   7-15              (4)  a judicial or administrative proceeding to
   7-16  substantiate and collect on a claim for mental or emotional health
   7-17  services rendered to the patient;
   7-18              (5)  a judicial proceeding if the judge finds that the
   7-19  patient, after having been informed that communications would not
   7-20  be privileged, has made communications to a professional in the
   7-21  course of a court-ordered examination relating to the patient's
   7-22  mental or emotional condition or disorder, except that those
   7-23  communications may be disclosed only with respect to issues
   7-24  involving the patient's mental or emotional health;
   7-25              (6)  a judicial proceeding affecting the parent-child
   7-26  relationship;
   7-27              (7)  any criminal proceeding, as otherwise provided by
   7-28  law;
   7-29              (8)  a judicial or administrative proceeding regarding
   7-30  the abuse or neglect, or the cause of abuse or neglect, of a
   7-31  resident of an institution, as that term is defined by Chapter 242;
   7-32              (9)  a judicial proceeding relating to a will if the
   7-33  patient's physical or mental condition is relevant to the execution
   7-34  of the will;
   7-35              (10)  an involuntary commitment proceeding for
   7-36  court-ordered treatment or for a probable cause hearing under:
   7-37                    (A)  Chapter 462;
   7-38                    (B)  Chapter 574; or
   7-39                    (C)  Chapter 593; or
   7-40              (11)  a judicial or administrative proceeding where the
   7-41  court or agency has issued an order or subpoena.
   7-42        (b)  On granting an order under Subsection (a)(5), the court,
   7-43  in determining the extent to which disclosure of all or any part of
   7-44  a communication is necessary, shall impose appropriate safeguards
   7-45  against unauthorized disclosure.
   7-46        Sec. 611.007.  REVOCATION OF CONSENT.  (a)  Except as
   7-47  provided by Subsection (b), a patient or a patient's legally
   7-48  authorized representative may revoke a disclosure consent to a
   7-49  professional at any time.  A revocation is valid only if it is
   7-50  written, dated, and signed by the patient or legally authorized
   7-51  representative.
   7-52        (b)  A patient may not revoke a disclosure that is required
   7-53  for purposes of making payment to the professional for mental
   7-54  health care services provided to the patient.
   7-55        (c)  A patient may not maintain an action against a
   7-56  professional for a disclosure made by the professional in good
   7-57  faith reliance on an authorization if the professional did not have
   7-58  notice of the revocation of the consent.
   7-59        Sec. 611.008.  REQUEST BY PATIENT.  (a)  On receipt of a
   7-60  written request from a patient to examine or copy all or part of
   7-61  the patient's recorded mental health care information, a
   7-62  professional, as promptly as required under the circumstances but
   7-63  not later than the 15th day after the date of receiving the
   7-64  request, shall:
   7-65              (1)  make the information available for examination
   7-66  during regular business hours and provide a copy to the patient, if
   7-67  requested; or
   7-68              (2)  inform the patient if the information does not
   7-69  exist or cannot be found.
   7-70        (b)  Unless provided for by other state law, the professional
    8-1  may charge a reasonable fee for retrieving or copying mental health
    8-2  care information and is not required to permit examination or
    8-3  copying until the fee is paid unless there is a medical emergency.
    8-4        (c)  A professional may not charge a fee for copying mental
    8-5  health care information under Subsection (b) to the extent the fee
    8-6  is prohibited under Subchapter M, Chapter 161.
    8-7        SECTION 9.  Subsection (g), Section 241.152, and Subsection
    8-8  (c), Section 611.008, Health and Safety Code, and Subsection (p),
    8-9  Section 5.08, Medical Practice Act (Article 4495b, Vernon's Texas
   8-10  Civil Statutes), take effect only if S.B. No. 133, 74th
   8-11  Legislature, Regular Session, 1995, is enacted and becomes law.  If
   8-12  S.B. No. 133 does not become law, those provisions have no effect.
   8-13        SECTION 10.  This Act applies to the disclosure of health
   8-14  care information, medical records, and mental health care
   8-15  information on or after January 1, 1996.
   8-16        SECTION 11.  This Act takes effect September 1, 1995.
   8-17        SECTION 12.  The importance of this legislation and the
   8-18  crowded condition of the calendars in both houses create an
   8-19  emergency and an imperative public necessity that the
   8-20  constitutional rule requiring bills to be read on three several
   8-21  days in each house be suspended, and this rule is hereby suspended.
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