75R13588 DLF-F
By Zaffirini S.B. No. 802
Substitute the following for S.B. No. 802:
By Berlanga C.S.S.B. No. 802
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the collection of certain information related to health
1-3 care and the functions and duties of the Texas Health Care
1-4 Information Council; providing a penalty.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. Section 108.002, Health and Safety Code, is
1-7 amended to read as follows:
1-8 Sec. 108.002. DEFINITIONS. In this chapter:
1-9 (1) "Board" means the Texas Board of Health.
1-10 (2) "Charge" or "rate" means the amount billed by a
1-11 provider for specific procedures or services provided to a patient
1-12 before any adjustment for contractual allowances. The term does
1-13 not include copayment charges to enrollees in health benefit plans
1-14 charged [maintenance organization enrollees] by providers paid by
1-15 capitation or salary [in a health maintenance organization].
1-16 (3) "Council" means the Texas Health Care Information
1-17 Council.
1-18 (4) "Data" means information collected under Section
1-19 108.009 in the form initially received.
1-20 (5) "Department" means the Texas Department of Health.
1-21 (6) "Health benefit plan" means a plan provided by:
1-22 (A) a health maintenance organization; or
1-23 (B) an approved nonprofit health corporation
1-24 that is certified under Section 5.01(a), Medical Practice
2-1 Act (Article 4495b, Vernon's Texas Civil Statutes), and that
2-2 holds a certificate of authority issued by the commissioner of
2-3 insurance under Article 21.52F, Insurance Code.
2-4 (7) [(6)] "Health care facility" means:
2-5 (A) a hospital;
2-6 (B) an ambulatory surgical center licensed under
2-7 Chapter 243;
2-8 (C) a chemical dependency treatment facility
2-9 licensed under Chapter 464;
2-10 (D) a renal dialysis facility;
2-11 (E) a birthing center;
2-12 (F) a rural health clinic; or
2-13 (G) a federally qualified health center as
2-14 defined by 42 U.S.C. Section 1396d(l)(2)(B).
2-15 (8) [(7)] "Health maintenance organization" means an
2-16 organization as defined in Section 2, Texas Health Maintenance
2-17 Organization Act (Article 20A.02, Vernon's Texas Insurance Code).
2-18 (9) [(8)] "Hospital" means a public, for-profit, or
2-19 nonprofit institution licensed or owned by this state that is a
2-20 general or special hospital, private mental hospital, chronic
2-21 disease hospital, or other type of hospital.
2-22 (10) [(9)] "Outcome data" means measures related to
2-23 the provision of care, including:
2-24 (A) patient demographic information;
2-25 (B) patient length of stay;
2-26 (C) mortality;
2-27 (D) co-morbidity;
3-1 (E) complications; and
3-2 (F) charges.
3-3 (11) [(10)] "Physician" means an individual licensed
3-4 under the laws of this state to practice medicine under the Medical
3-5 Practice Act (Article 4495b, Vernon's Texas Civil Statutes).
3-6 (12) [(11)] "Provider" means a physician or[,] health
3-7 care facility[, or health maintenance organization].
3-8 (13) [(12)] "Provider quality" means the extent to
3-9 which a provider renders care that, within the capabilities of
3-10 modern medicine, obtains for patients medically acceptable health
3-11 outcomes and prognoses, after severity adjustment.
3-12 (14) "Public use data" means patient level data
3-13 relating to individual hospitalizations that has not been
3-14 summarized or analyzed, that identifies patients and physicians
3-15 only by use of uniform patient and physician identifiers, and that
3-16 is severity and risk adjusted and verified for accuracy.
3-17 (15) [(13)] "Rural provider" means a provider
3-18 described by Section 108.0025 [located in:]
3-19 [(A) a county with a population of not more than
3-20 35,000;]
3-21 [(B) those portions of extended cities that the
3-22 United States Bureau of the Census has determined to be rural; or]
3-23 [(C) an area that is not delineated as an
3-24 urbanized area by the United States Bureau of the Census].
3-25 (16) [(14)] "Severity adjustment" means a method to
3-26 stratify patient groups by degrees of illness and mortality.
3-27 (17) [(15)] "Uniform patient identifier" means a
4-1 number assigned by the council to an individual patient and
4-2 composed of numeric, alpha, or alphanumeric characters.
4-3 (18) [(16)] "Uniform physician identifier" means a
4-4 number assigned by the council to an individual physician and
4-5 composed of numeric, alpha, or alphanumeric characters.
4-6 SECTION 2. Chapter 108, Health and Safety Code, is amended
4-7 by adding Section 108.0025 to read as follows:
4-8 Sec. 108.0025. RURAL PROVIDER. For purposes of this
4-9 chapter, a provider is a rural provider if the provider:
4-10 (1) is located in a county that:
4-11 (A) has a population estimated by the United
4-12 States Bureau of the Census to be not more than 35,000 as of July 1
4-13 of the most recent year for which county population estimates have
4-14 been published; or
4-15 (B) has a population of more than 35,000, but
4-16 that does not have more than 100 licensed hospital beds and is not
4-17 located in an area that is delineated as an urbanized area by the
4-18 United States Bureau of the Census; and
4-19 (2) is not a state-owned hospital or a hospital that
4-20 is managed or directly or indirectly owned by an individual,
4-21 association, partnership, corporation, or other legal entity that
4-22 owns or manages one or more other hospitals.
4-23 SECTION 3. Sections 108.003(a), (b), (c), (f), and (g),
4-24 Health and Safety Code, are amended to read as follows:
4-25 (a) The council is composed of four [three nonvoting] ex
4-26 officio state agency members and 15 members appointed by the
4-27 governor in accordance with this section.
5-1 (b) The [nonvoting] ex officio members of the council are:
5-2 (1) the commissioner of public health or the
5-3 commissioner's designee;
5-4 (2) the commissioner of health and human services or
5-5 the commissioner's designee; [and]
5-6 (3) the commissioner of insurance or the
5-7 commissioner's designee; and
5-8 (4) the public insurance counsel, or the counsel's
5-9 designee.
5-10 (c) The governor shall appoint the following members of the
5-11 council:
5-12 (1) three representatives of the business community,
5-13 with at least one representing small businesses, who are purchasers
5-14 of health care but who are not involved in the provision of health
5-15 care or health insurance;
5-16 (2) two representatives from labor, one of whom is not
5-17 directly involved with management of health care benefits;
5-18 (3) two representatives of consumers who are not
5-19 professionally involved in the purchase, provision, administration,
5-20 or review of health care or health care insurance;
5-21 (4) two representatives of hospitals;
5-22 (5) one representative of health maintenance
5-23 organizations;
5-24 (6) three representatives of physicians who are
5-25 involved in direct patient care; and
5-26 (7) two members who are not professionally involved in
5-27 the purchase, provision, administration, or utilization review of
6-1 health care or health care insurance and who have expertise in:
6-2 (A) health planning;
6-3 (B) health economics;
6-4 (C) provider quality assurance;
6-5 (D) information systems [statistics or health
6-6 data management]; or
6-7 (E) the reimbursement of medical education and
6-8 research costs.
6-9 (f) The council may appoint committees [subcommittees] and
6-10 may elect any officers subordinate to those provided for in
6-11 Subsection (d).
6-12 (g) The council shall appoint technical advisory committees
6-13 and shall consult with the appropriate technical advisory committee
6-14 with respect to a rule before the rule is finally adopted by the
6-15 council. The council is not required to consult with a technical
6-16 advisory committee before adopting an emergency rule in accordance
6-17 with Section 2001.034, Government Code. The council shall submit an
6-18 emergency rule adopted by the council to the appropriate advisory
6-19 committee for review not later than the first advisory committee
6-20 meeting that occurs after the rule is adopted. The council may
6-21 consult with the appropriate technical advisory committee with
6-22 respect to other formal action of the council. A technical advisory
6-23 committee may consult with other professionals as necessary[. The
6-24 technical advisory committees shall work in coordination with each
6-25 other and may consult with other professionals, as necessary]. The
6-26 technical advisory committees shall include:
6-27 (1) a technical advisory committee that includes,
7-1 among other individuals, at least five practicing physicians
7-2 licensed in this state to provide advice and recommendations to the
7-3 council on:
7-4 (A) the development and implementation of the
7-5 methodology and the interpretation of provider quality data under
7-6 Section 108.010; and
7-7 (B) the development and dissemination of
7-8 consumer education information and materials;
7-9 (2) a technical advisory committee composed of at
7-10 least five practicing physicians licensed in this state who have
7-11 been actively engaged in organized peer review at a hospital in
7-12 this state to provide advice, recommendations, and peer review
7-13 expertise to the council on:
7-14 (A) the use of peer review in the determination
7-15 of quality inpatient care;
7-16 (B) the development and interpretation of data
7-17 elements necessary to the determination of quality inpatient care;
7-18 and
7-19 (C) the development and format of reports and
7-20 information relating to provider quality;
7-21 (3) a technical advisory committee composed of
7-22 individuals who have expertise in the reimbursement of medical
7-23 education and research costs; [and]
7-24 (4) a technical advisory committee composed of
7-25 representatives of each type of issuer of health benefit plans
7-26 [maintenance organizations] to assist the council in complying with
7-27 Section 108.009(o); and
8-1 (5) a technical advisory committee composed of
8-2 individuals who have expertise in hospital information systems,
8-3 health information management, and quality management.
8-4 SECTION 4. Sections 108.004(a) and (c), Health and Safety
8-5 Code, are amended to read as follows:
8-6 (a) The council, council committees [subcommittees], and
8-7 technical advisory committees are subject to the open meetings law,
8-8 Chapter 551, Government Code.
8-9 (c) The council shall publish a notice of its meetings in
8-10 the Texas Register [at least four newspapers of general circulation
8-11 in this state].
8-12 SECTION 5. Chapter 108, Health and Safety Code, is amended
8-13 by adding Section 108.0045 to read as follows:
8-14 Sec. 108.0045. OPEN RECORDS. Subject to the restrictions of
8-15 this chapter, the council is subject to the open records law,
8-16 Chapter 552, Government Code.
8-17 SECTION 6. Sections 108.006(a), (b), and (d), Health and
8-18 Safety Code, are amended to read as follows:
8-19 (a) The council shall develop a statewide health care data
8-20 collection system to collect health care charges, utilization data,
8-21 provider quality data, and outcome data to facilitate the promotion
8-22 and accessibility of cost-effective, good quality health care. The
8-23 council shall:
8-24 (1) direct the collection, dissemination, and analysis
8-25 of data under this chapter;
8-26 (2) contract with the department to collect the data
8-27 under this chapter;
9-1 (3) adopt policies and rules necessary to carry out
9-2 this chapter, including rules concerning data collection
9-3 requirements;
9-4 (4) build on and not duplicate other data collection
9-5 required by state or federal law, by an accreditation organization,
9-6 or by board rule;
9-7 (5) working with appropriate agencies, review public
9-8 health data collection programs in this state and recommend, where
9-9 appropriate, consolidation of the programs and any legislation
9-10 necessary to effect the consolidation;
9-11 (6) assure that public use data [collected] is made
9-12 available and accessible to interested persons;
9-13 (7) prescribe by rule the process [a format] for
9-14 providers to submit data consistent with Section 108.009;
9-15 (8) adopt by rule and implement a methodology to
9-16 collect and disseminate data reflecting provider quality in
9-17 accordance with Section 108.010;
9-18 (9) make reports to the legislature, the governor, and
9-19 the public on:
9-20 (A) the charges and rate of change in the
9-21 charges for health care services in this state;
9-22 (B) the effectiveness of the council in carrying
9-23 out the legislative intent of this chapter;
9-24 (C) if applicable, any recommendations on the
9-25 need for further legislation; and
9-26 (D) the quality and effectiveness of health care
9-27 and access to health care for all citizens of this state;
10-1 (10) develop an annual work plan and establish
10-2 priorities to accomplish its duties;
10-3 (11) provide consumer education on the interpretation
10-4 and understanding of the public use or provider quality data before
10-5 the data is disseminated [information that is released] to the
10-6 public;
10-7 (12) work with the Health and Human Services
10-8 Commission and each health and human services agency that
10-9 administers a part of the state Medicaid program to avoid
10-10 duplication of expenditures of state funds for computer systems,
10-11 staff, or services in the collection and analysis of data relating
10-12 to the state Medicaid program; [and]
10-13 (13) work with the Department of Information Resources
10-14 in developing and implementing the statewide health care data
10-15 collection system and maintain consistency with Department of
10-16 Information Resources standards; and
10-17 (14) develop and implement a health care information
10-18 plan to be used by the department to:
10-19 (A) support public health and preventative
10-20 health initiatives;
10-21 (B) assist in the delivery of primary and
10-22 preventive health care services;
10-23 (C) facilitate the establishment of appropriate
10-24 benchmark data to measure performance improvements;
10-25 (D) establish and maintain a systematic approach
10-26 to the collection, storage, and analysis of health care data for
10-27 longitudinal, epidemiological, and policy impact studies; and
11-1 (E) develop and use system-based protocols to
11-2 identify individuals and populations at risk.
11-3 (b) The council may:
11-4 (1) employ or contract with the department to employ
11-5 an executive director and other staff, including administrative
11-6 [and legal] personnel, necessary to comply with this chapter and
11-7 rules adopted under this chapter;
11-8 (2) engage professional consultants as it considers
11-9 necessary to the performance of its duties;
11-10 (3) adopt rules clarifying which health care
11-11 facilities must provide data under this chapter; and
11-12 (4) apply for and receive any appropriation, donation,
11-13 or other funds from the state or federal government or any other
11-14 public or private source, subject to Section 108.015 and
11-15 limitations and conditions provided by legislative appropriation.
11-16 (d) The council may not take an action that affects or
11-17 relates to the validity, status, or terms of an [a department]
11-18 interagency agreement or a contract with the department without the
11-19 board's approval.
11-20 SECTION 7. Sections 108.008(b) and (c), Health and Safety
11-21 Code, are amended to read as follows:
11-22 (b) The department shall:
11-23 (1) contract with the council to collect data under
11-24 this chapter;
11-25 (2) provide administrative [and legal] assistance to
11-26 the council [in accordance with rules adopted by the board after
11-27 consulting with the council and set out in the contract with the
12-1 council];
12-2 (3) coordinate administrative responsibilities with
12-3 the council to avoid unnecessary duplication of the collection of
12-4 data and other duties;
12-5 (4) on request of the council, give the council access
12-6 to data collected by the department [on request of the council];
12-7 (5) submit or assist in the council's budget request
12-8 to the legislature; and
12-9 (6) work with the Department of Information Resources
12-10 in developing and implementing the statewide health care data
12-11 collection system and maintain consistency with Department of
12-12 Information Resources standards.
12-13 (c) The department may not take an action that affects or
12-14 relates to the validity, status, or terms of an [a council]
12-15 interagency agreement or a contract with the council without the
12-16 council's approval.
12-17 SECTION 8. Chapter 108, Health and Safety Code, is amended
12-18 by adding Sections 108.0081 and 108.0085 to read as follows:
12-19 Sec. 108.0081. MEMORANDUM OF UNDERSTANDING. The council and
12-20 the department shall enter into a memorandum of understanding to
12-21 implement the department's duties under Section 108.008(b). The
12-22 memorandum of understanding must address:
12-23 (1) payroll and travel reimbursement services;
12-24 (2) purchasing services;
12-25 (3) personnel services;
12-26 (4) budget management services;
12-27 (5) computer support and maintenance services;
13-1 (6) meeting coordination services;
13-2 (7) any other administrative support or other services
13-3 to be provided by the department for the council; and
13-4 (8) the manner in which the council will reimburse the
13-5 department for the cost of services provided by the department for
13-6 the council.
13-7 Sec. 108.0085. DUTIES OF ATTORNEY GENERAL. The attorney
13-8 general shall furnish the council with advice and legal assistance
13-9 that may be required to implement this chapter.
13-10 SECTION 9. Sections 108.009(b), (c), (d), (h), (k), and (o),
13-11 Health and Safety Code, are amended to read as follows:
13-12 (b) The council shall adopt rules to implement the data
13-13 submission requirements imposed by Subsection (a) in appropriate
13-14 stages to allow for the development of efficient systems for the
13-15 collection and submission of the data. A commission rule that
13-16 requires submission of a data element that, before adoption of the
13-17 rule, was not required to be submitted may not take effect before
13-18 the 90th day after the date the rule is adopted.
13-19 (c) A rural provider may, but is not required to, provide
13-20 the data required by this chapter [section]. A hospital may, but
13-21 is not required to, provide the data required by this chapter if
13-22 the hospital:
13-23 (1) is exempt from state franchise, sales, ad valorem,
13-24 or other state or local taxes; and
13-25 (2) does not seek or receive reimbursement for
13-26 providing health care services to patients from any source,
13-27 including:
14-1 (A) the patient or any person legally obligated
14-2 to support the patient;
14-3 (B) a third-party payor; or
14-4 (C) Medicaid, Medicare, or any other federal,
14-5 state, or local program for indigent health care.
14-6 (d) The council may not collect data from individual
14-7 physicians or from an entity that is composed entirely of
14-8 physicians and that is a professional association organized under
14-9 the Texas Professional Association Act (Article 1528f, Vernon's
14-10 Texas Civil Statutes), a limited liability partnership organized
14-11 under Section 3.08, Texas Revised Partnership Act (Article
14-12 6132b-3.08, Vernon's Texas Civil Statutes), or a limited liability
14-13 company organized under the Texas Limited Liability Company Act
14-14 (Article 1528n, Vernon's Texas Civil Statutes), except to the
14-15 extent the entity owns and operates a health care facility in this
14-16 state. This subsection does not prohibit the release of data about
14-17 physicians using uniform physician identifiers that has been
14-18 collected from a health care facility under this chapter.
14-19 (h) The council shall[, to the extent feasible,] coordinate
14-20 data collection with the data submission [collection] formats used
14-21 by hospitals and other providers. The council shall accept data in
14-22 the format developed by the National Uniform Billing Committee
14-23 (Uniform Hospital Billing Form UB 92) and HCFA-1500 or their
14-24 successors or other universally accepted standardized forms that
14-25 hospitals and other providers use for other complementary purposes
14-26 [approved by the council].
14-27 (k) The [In developing the statewide health care data
15-1 collection system, the] council shall collect [identify] health
15-2 care data elements relating to [health care charges, provider
15-3 quality,] payer type, the racial and ethnic background of
15-4 patients, [the outcome data related to health care services,] and
15-5 the use of health care services by consumers.
15-6 (o) A provider of a health benefit plan [maintenance
15-7 organization] shall annually submit to the council aggregate data
15-8 by service area required by the Health Plan Employer Data
15-9 Information Set (HEDIS) as operated by the National Committee for
15-10 Quality Assurance. The council may approve the submission of data
15-11 in accordance with other methods generally used by the health
15-12 benefit plan [maintenance organization] industry. This subsection
15-13 does not relieve a health care facility that provides services
15-14 under [to] a health benefit plan [maintenance organization] from
15-15 the requirements of this chapter. Information submitted under this
15-16 section is subject to Section 108.011 but is not subject to Section
15-17 108.010.
15-18 SECTION 10. Section 108.010, Health and Safety Code, is
15-19 amended by amending Subsections (b), (c), (d), (e), (g), and (h)
15-20 and adding Subsection (i) to read as follows:
15-21 (b) The [After a majority of the council has been appointed,
15-22 the] council shall study and analyze initial methodologies for
15-23 obtaining provider quality data, including outcome data. [The
15-24 council shall adopt an initial methodology not later than January
15-25 1, 1997, but may not adopt the initial methodology before the first
15-26 anniversary of the date on which a majority of the council is
15-27 appointed. If the council determines additional time for
16-1 development of the initial methodology is needed, the council, by a
16-2 two-thirds vote of the full council, may extend the deadline
16-3 established by this subsection for adopting the initial
16-4 methodology.]
16-5 (c) The council shall test the methodology by collecting
16-6 provider quality data for one year, subject to Section 108.009.
16-7 The council may test using pilot methodologies. After collecting
16-8 provider quality data for one year, the council shall report
16-9 findings applicable to a provider to that provider and allow the
16-10 provider to review and comment on the initial provider quality
16-11 [outcome] data applicable to that provider. The council shall
16-12 verify the accuracy of the data during this review and revision
16-13 process. After the review and revision process, provider quality
16-14 [outcome] data for subsequent reports shall be published and made
16-15 available to the public, on a time schedule the council considers
16-16 appropriate.
16-17 (d) If the council determines that provider quality
16-18 [outcome] data to be published under Subsection (c) does not
16-19 provide the intended result or is inaccurate or inappropriate for
16-20 dissemination, the council is not required to publish the data or
16-21 reports based in whole or in part on the data. This subsection
16-22 does not affect the release of public use data in accordance with
16-23 [collected under] Section 108.011 or the release of information
16-24 submitted under Section 108.009(o) [108.009].
16-25 (e) The council shall adopt rules allowing a provider to
16-26 submit concise written comments regarding any specific provider
16-27 quality data to be released concerning the provider. The council
17-1 shall make the comments available to the public at the office of
17-2 the council and in an electronic form accessible through the
17-3 Internet. The comments shall [may] be attached to any public
17-4 release of provider quality data. Providers shall submit the
17-5 comments to the council to be attached to the public release of
17-6 provider quality data in the same format as the provider quality
17-7 data that is to be released.
17-8 (g) In addition to the requirements of this section, any
17-9 release of provider quality data shall comply with Sections
17-10 108.011(e) and (f) [108.011(d)-(f)].
17-11 (h) A provider quality [outcome] data report may not
17-12 identify an individual physician by name, but must identify the
17-13 physician by the uniform physician identifier designated by the
17-14 council under Section 108.011(c).
17-15 (i) The council shall release provider quality data relating
17-16 to providers described by Section 108.0025(1), but that are not
17-17 rural providers because they do not meet the requirement of Section
17-18 108.0025(2), in an aggregate form without uniform patient and
17-19 physician identifiers.
17-20 SECTION 11. Sections 108.011 and 108.012, Health and Safety
17-21 Code, are amended to read as follows:
17-22 Sec. 108.011. [DATA] DISSEMINATION OF PUBLIC USE DATA AND
17-23 COUNCIL PUBLICATIONS [PUBLICATION]. (a) The council shall
17-24 promptly provide public use data and data collected in accordance
17-25 with Section 108.009(o) to those requesting it. The public use
17-26 data does not include provider quality [, subject to the
17-27 restrictions on access to council] data prescribed by Section
18-1 [Sections] 108.010 or confidential data prescribed by Section [and]
18-2 108.013.
18-3 (b) Subject to the restrictions on access to council data
18-4 prescribed by Sections 108.010 and 108.013, and using the public
18-5 use data [collected under Section 108.009] and other data, records,
18-6 and matters of record available to it, the council shall prepare
18-7 and issue reports to the governor, the legislature, and the public
18-8 as provided by this section and Section 108.006(a). The council
18-9 must issue the reports at least annually.
18-10 (c) Subject to the restrictions on access to council data
18-11 prescribed by Sections 108.010 and 108.013, the council shall use
18-12 public use data to prepare and issue reports that provide
18-13 information relating to providers, such as the incidence rate of
18-14 selected medical or surgical procedures [and the provider quality].
18-15 The reports must provide the data in a manner that identifies
18-16 individual providers, including individual physicians, and that
18-17 identifies and compares data elements for all providers.
18-18 Individual physicians may not be identified by name, but shall be
18-19 identified by uniform physician identifiers. The council by rule
18-20 shall designate the characters to be used as uniform physician
18-21 identifiers.
18-22 (d) The council shall adopt procedures to verify the
18-23 accuracy of the public use data before releasing [a report
18-24 containing] the public use data [is released] to the public.
18-25 (e) If public use [provider] data is requested from the
18-26 council about [for] a specific provider, the council shall notify
18-27 the provider about the release of the data. This subsection does
19-1 not authorize the provider to interfere with the release of that
19-2 data.
19-3 (f) A report issued by the council shall include a
19-4 reasonable review and comment period for the affected providers
19-5 before public release of the report.
19-6 (g) The council shall adopt rules allowing a provider to
19-7 submit concise written comments regarding any specific public use
19-8 data to be released concerning the provider. The council shall make
19-9 the comments available to the public and the office of the council
19-10 and in an electronic form accessible through the Internet. The
19-11 comments shall be attached to any public release of the public use
19-12 data. Providers shall submit the comments to the council to be
19-13 attached to the public release of public use data in the same
19-14 format as the public use data that is to be released.
19-15 (h) Tapes containing public use data and provider quality
19-16 reports that are released to the public must include general
19-17 consumer education material, including an explanation of the
19-18 benefits and limitations of the information provided in the public
19-19 use data and provider quality reports.
19-20 (i) The council shall release public use data relating to
19-21 providers described by Section 108.0025(1), but that are not rural
19-22 providers because they do not meet the requirement of Section
19-23 108.0025(2), in an aggregate form without uniform patient and
19-24 physician identifiers.
19-25 Sec. 108.012. COMPUTER ACCESS TO DATA. (a) The council
19-26 shall provide a means for computer-to-computer access to the public
19-27 use data. All reports shall maintain patient confidentiality as
20-1 provided by Section 108.013.
20-2 (b) The council may charge a person requesting public use or
20-3 provider quality data a fee for the data. The fees may reflect the
20-4 quantity of information provided and the expense incurred by the
20-5 council in collecting and providing the data and shall be set at a
20-6 level that will raise revenue sufficient for the operation of the
20-7 council. The council may not charge a fee for providing public use
20-8 data to another state agency.
20-9 SECTION 12. Section 108.013, Health and Safety Code, is
20-10 amended by amending Subsections (a), (b), and (e) and adding
20-11 Subsections (g), (h), and (i) to read as follows:
20-12 (a) The data received by the council shall be used by the
20-13 council for the benefit of the public. [The council is subject to
20-14 the open records law, Chapter 552, Government Code.] Subject to
20-15 specific limitations established by this chapter and council rule,
20-16 the council shall make determinations on requests for information
20-17 in favor of access.
20-18 (b) The council by rule shall designate the characters to be
20-19 used [by providers] as uniform patient identifiers. The basis for
20-20 assignment of the characters and the manner in which the characters
20-21 are assigned are confidential.
20-22 (e) Data on patients and physicians and compilations[,
20-23 reports, or analyses] produced from the data collected that
20-24 identify patients and physicians are not:
20-25 (1) subject to discovery, subpoena, or other means of
20-26 legal compulsion for release to any person or entity except as
20-27 provided by this section; or
21-1 (2) admissible in any civil, administrative, or
21-2 criminal proceeding.
21-3 (g) The council may not release data elements in a manner
21-4 that will reveal the identity of a physician or patient.
21-5 (h) Subsection (c)(1) and Subsection (g) do not prohibit the
21-6 release of a uniform physician identifier or a uniform patient
21-7 identifier in conjunction with associated public use data in
21-8 accordance with Section 108.011 or provider quality data in
21-9 accordance with Section 108.010.
21-10 (i) Notwithstanding any other law, the council and the
21-11 department may not provide information made confidential by this
21-12 section to any other agency of this state.
21-13 SECTION 13. Chapter 108, Health and Safety Code, is amended
21-14 by adding Section 108.0141 to read as follows:
21-15 Sec. 108.0141. CRIMINAL PENALTY. (a) A person who with
21-16 criminal negligence releases data in violation of this chapter
21-17 commits an offense.
21-18 (b) An offense under this section is a Class A misdemeanor.
21-19 SECTION 14. Sections 108.009(j), (l), and (n), Health and
21-20 Safety Code, are repealed.
21-21 SECTION 15. Subchapter C, Chapter 311, Health and Safety
21-22 Code, is amended by adding Section 311.039 to read as follows:
21-23 Sec. 311.039. EXEMPTION. A hospital may, but is not
21-24 required to, provide the data required by Section 311.033 if the
21-25 hospital:
21-26 (1) is exempt from state franchise, sales, ad valorem,
21-27 or other state or local taxes; and
22-1 (2) does not seek or receive reimbursement for
22-2 providing health care services to patients from any source,
22-3 including:
22-4 (A) the patient or any person legally obligated
22-5 to support the patient;
22-6 (B) a third party payor; or
22-7 (C) Medicaid, Medicare, or any other federal,
22-8 state, or local program for indigent health care.
22-9 SECTION 16. The change in law made by this Act applies only
22-10 to the collection and dissemination of data under Chapter 108,
22-11 Health and Safety Code, on or after the effective date of this Act.
22-12 The collection and dissemination of data before the effective date
22-13 of this Act is governed by the law as it existed immediately before
22-14 the effective date of this Act, and that law is continued in effect
22-15 for that purpose.
22-16 SECTION 17. This Act takes effect September 1, 1997.
22-17 SECTION 18. The importance of this legislation and the
22-18 crowded condition of the calendars in both houses create an
22-19 emergency and an imperative public necessity that the
22-20 constitutional rule requiring bills to be read on three several
22-21 days in each house be suspended, and this rule is hereby suspended.