By Smithee H.R. No. 1315
Line and page numbers may not match official copy.
Bill not drafted by TLC or Senate E&E.
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,
2-1 Government Code.
2-2 (6) The office of public insurance counsel may not
2-3 make public confidential information provided to the office under
2-4 this subsection but may disclose a summary of the information that
2-5 does not directly or indirectly identify the health maintenance
2-6 organization that is the subject of the information. The office of
2-7 public insurance counsel may not release, and a person or entity
2-8 may not gain access to, any information that:
2-9 (A) could reasonably be expected to reveal the
2-10 identity of a patient or physician or that reveals the zip code of
2-11 a patient's primary residence;
2-12 (B) discloses provider discounts or
2-13 differentials between payments and billed charges; or
2-14 (C) relates to actual payments to an identified
2-15 provider made by a payer.
2-16 (7) Information collected or used by the office of
2-17 public insurance counsel under this subsection is subject to the
2-18 confidentiality provisions and criminal penalties of:
2-19 (A) Section 81.103, Health and Safety Code;
2-20 (B) Section 311.037, Health and Safety Code; and
2-21 (C) Section 5.08, Medical Practice Act (Article
2-22 4495b, Vernon's Texas Civil Statutes).
2-23 (8) Information that is in the possession of the
2-24 office of public insurance counsel and that relates to patients and
2-25 physicians and any compilation, report, or analysis produced from
3-1 the information that identifies patients and physicians are not:
3-2 (A) subject to discovery, subpoena, or other
3-3 means of legal compulsion for release to any person or entity; or
3-4 (B) admissible in any civil, administrative, or
3-5 criminal proceeding.
3-6 (9) Notwithstanding Subdivision (6)(A) of this
3-7 subsection, the office of public insurance counsel may use zip code
3-8 information to analyze information on a geographic basis.
3-9 (10) The office may not endorse or recommend a
3-10 specific health maintenance organization or plan, or subjectively
3-11 rate or rank such organizations or plans, other than through
3-12 comparison and evaluation of objective criteria.
3-13 Explanation: These changes are necessary to provide adequate
3-14 confidentiality provisions to protect information reviewed by the
3-15 office of public insurance counsel, and to ensure that evaluations
3-16 and comparisons of health maintenance organizations are done on a
3-17 fair and objective basis.