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.