R E S O L U T I O N 1-1 BE IT RESOLVED by the House of Representatives of the State 1-2 of Texas, 75th Legislature, Regular Session, 1997, That House Rule 1-3 13, Section 9(a), be suspended in part as provided by House Rule 1-4 13, Section 9(f), to enable the conference committee appointed to 1-5 resolve the differences on S.B. No. 385 to consider and take action 1-6 on the following specific matters: 1-7 House Rule 13, Sections 9(a)(2) and (3), are suspended to 1-8 permit the committee to change Subsection (e)(4), and add 1-9 Subsections (e)(5)-(10), Article 1.35A, Insurance Code, to read as 1-10 follows: 1-11 (4) The office of public insurance counsel shall use 1-12 the information collected or received under this subsection for the 1-13 benefit of the public. Except as provided by this subsection, the 1-14 information is subject to the open records law, Chapter 552, 1-15 Government Code, and the office of public insurance counsel shall 1-16 make determinations on requests for information in favor of access. 1-17 (5) The office of public insurance counsel is entitled 1-18 to information that is confidential under any law of this state, 1-19 including Section 27, Texas Health Maintenance Organization Act 1-20 (Article 20A.27, Vernon's Texas Insurance Code), Chapter 108, 1-21 Health and Safety Code, and the open records law, Chapter 552, 1-22 Government Code. 1-23 (6) The office of public insurance counsel may not 1-24 make public confidential information provided to the office under 2-1 this subsection but may disclose a summary of the information that 2-2 does not directly or indirectly identify the health maintenance 2-3 organization that is the subject of the information. The office of 2-4 public insurance counsel may not release, and a person or entity 2-5 may not gain access to, any information that: 2-6 (A) could reasonably be expected to reveal the 2-7 identity of a patient or physician or that reveals the zip code of 2-8 a patient's primary residence; 2-9 (B) discloses provider discounts or 2-10 differentials between payments and billed charges; or 2-11 (C) relates to actual payments to an identified 2-12 provider made by a payer. 2-13 (7) Information collected or used by the office of 2-14 public insurance counsel under this subsection is subject to the 2-15 confidentiality provisions and criminal penalties of: 2-16 (A) Section 81.103, Health and Safety Code; 2-17 (B) Section 311.037, Health and Safety Code; and 2-18 (C) Section 5.08, Medical Practice Act (Article 2-19 4495b, Vernon's Texas Civil Statutes). 2-20 (8) Information that is in the possession of the 2-21 office of public insurance counsel and that relates to patients and 2-22 physicians and any compilation, report, or analysis produced from 2-23 the information that identifies patients and physicians are not: 2-24 (A) subject to discovery, subpoena, or other 2-25 means of legal compulsion for release to any person or entity; or 2-26 (B) admissible in any civil, administrative, or 2-27 criminal proceeding. 3-1 (9) Notwithstanding Subdivison (6)(A) of this 3-2 subsection, the office of public insurance counsel may use zip code 3-3 information to analyze information on a geographic basis. 3-4 (10) The office may not endorse or recommend a 3-5 specific health maintenance organization or plan, or subjectively 3-6 rate or rank such organizations or plans, other than through 3-7 comparison and evaluation of objective criteria. 3-8 Explanation: These changes are necessary to provide adequate 3-9 confidentiality provisions to protect information reviewed by the 3-10 office of public insurance counsel, and to ensure that evaluations 3-11 and comparisons of health maintenance organizations are done on a 3-12 fair and objective basis. Smithee _______________________________ Speaker of the House I certify that H.R. No. 1315 was adopted by the House on May 31, 1997, by a non-record vote. _______________________________ Chief Clerk of the House