By: Madla S.B. No. 975
A BILL TO BE ENTITLED
AN ACT
1-1 relating to the disclosure of health care information by certain
1-2 health care providers.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Section 241.151, Health and Safety Code, is
1-5 amended to read as follows:
1-6 Sec. 241.151. DEFINITIONS. In this subchapter:
1-7 (1) "Directory information" means information
1-8 disclosing the presence of a person who is receiving inpatient,
1-9 outpatient, or emergency services from a licensed hospital, the
1-10 nature of the person's injury, the person's municipality of
1-11 residence, sex, and age, and the general health status of the
1-12 person as described in terms of "critical," "poor," "fair," "good,"
1-13 "excellent," or similar terms.
1-14 (2) "Health care information" means information
1-15 recorded in any form or medium that identifies a patient and
1-16 relates to the history, diagnosis, treatment, or prognosis of a
1-17 patient.
1-18 (3) [(2)] "Health care provider" means a person who is
1-19 licensed, certified, or otherwise authorized by the laws of this
1-20 state to provide health care in the ordinary course of business or
1-21 practice of a profession.
1-22 (4) [(3)] "Institutional review board" means a board,
1-23 committee, or other group formally designated by an institution or
2-1 authorized under federal or state law to review or approve the
2-2 initiation of or conduct periodic review of research programs to
2-3 ensure the protection of the rights and welfare of human research
2-4 subjects.
2-5 (5) [(4)] "Legally authorized representative" means a
2-6 parent or legal guardian if the patient is a minor, a legal
2-7 guardian if the patient has been adjudicated incapacitated
2-8 [incompetent] to manage the patient's personal affairs, an agent of
2-9 the patient authorized under a durable power of attorney for health
2-10 care, an attorney ad litem appointed for the patient, a guardian ad
2-11 litem appointed for the patient, a personal representative or
2-12 statutory beneficiary if the patient is deceased, [or] an attorney
2-13 retained by the patient or by the patient's legally authorized
2-14 representative, or an attorney-in-fact of the patient.
2-15 SECTION 2. Subsections (a) and (c), Section 241.152, Health
2-16 and Safety Code, are amended to read as follows:
2-17 (a) Except as authorized by Section 241.153, a hospital or
2-18 an agent or employee of a hospital may not disclose health care
2-19 information about a patient to any person other than the patient or
2-20 the patient's legally authorized representative without the written
2-21 authorization of the patient or the patient's legally authorized
2-22 representative.
2-23 (c) A disclosure authorization is valid until the 180th
2-24 [90th] day after the date it is signed unless it provides otherwise
2-25 or unless it is revoked.
3-1 SECTION 3. Section 241.153, Health and Safety Code, is
3-2 amended to read as follows:
3-3 Sec. 241.153. DISCLOSURE WITHOUT WRITTEN AUTHORIZATION. A
3-4 patient's health care information may be disclosed without the
3-5 patient's authorization if the disclosure is:
3-6 (1) directory information, unless the patient has
3-7 instructed the hospital not to make the disclosure or the directory
3-8 information is otherwise protected by state or federal law;
3-9 (2) to a health care provider who is rendering health
3-10 care to the patient when the request for the disclosure is made;
3-11 (3) to a transporting emergency medical services
3-12 provider for the sole purpose of determining the patient's
3-13 diagnosis and the outcome of the patient's hospital admission;
3-14 (4) to a member of the clergy specifically designated
3-15 by the patient;
3-16 (5) to a qualified organ or tissue procurement
3-17 organization as defined in Section 692.002 for the purpose of
3-18 making inquiries relating to donations according to the protocol
3-19 referred to in Section 692.013(d);
3-20 (6) to a prospective health care provider for the
3-21 purpose of securing the services of that health care provider as
3-22 part of the patient's continuum of care, as determined by the
3-23 patient's attending physician;
3-24 (7) to a person authorized to consent to medical
3-25 treatment under Chapter 313 or to a person in a circumstance
4-1 exempted from Chapter 313 to facilitate the adequate provision of
4-2 treatment;
4-3 (8) [(2)] to an employee or agent of the hospital who
4-4 requires health care information for health care education, quality
4-5 assurance, or peer review or for assisting the hospital in the
4-6 delivery of health care or in complying with statutory, licensing,
4-7 accreditation, or certification requirements and if the hospital
4-8 takes appropriate action to ensure that the employee or agent:
4-9 (A) will not use or disclose the health care
4-10 information for any other purpose; and
4-11 (B) will take appropriate steps to protect the
4-12 health care information;
4-13 (9) [(3)] to a federal, state, or local government
4-14 agency or authority to the extent authorized or required by law;
4-15 (10) [(4)] to a hospital that is the successor in
4-16 interest to the hospital maintaining the health care information;
4-17 (11) to the American Red Cross for the specific
4-18 purpose of fulfilling the duties specified under its charter
4-19 granted as an instrumentality of the United States government;
4-20 (12) to a regional poison control center, as the term
4-21 is used in Chapter 777, to the extent necessary to enable the
4-22 center to provide information and education to health professionals
4-23 involved in the management of poison and overdose victims,
4-24 including information regarding appropriate therapeutic use of
4-25 medications, their compatibility and stability, and adverse drug
5-1 reactions and interactions;
5-2 (13) to a health care utilization review agent who
5-3 requires the health care information for utilization review of
5-4 health care under Article 21.58A, Insurance Code;
5-5 (14) [(5)] for use in a research project authorized by
5-6 an institutional review board under federal law;
5-7 (15) [(6)] to health care personnel of a penal or
5-8 other custodial institution in which the patient is detained if the
5-9 disclosure is for the sole purpose of providing health care to the
5-10 patient;
5-11 (16) [(7)] to facilitate reimbursement [by a health
5-12 benefit plan] to a hospital, other health care provider, or the
5-13 patient for medical services or supplies;
5-14 (17) [(8)] to a health maintenance organization for
5-15 purposes of maintaining a statistical reporting system as required
5-16 by a rule adopted by a state agency or regulations adopted under
5-17 the federal Health Maintenance Organization Act of 1973, as amended
5-18 (42 U.S.C. Section 300 et seq.);
5-19 (18) [(9)] to satisfy a request for medical records of
5-20 a deceased or incompetent person pursuant to Section 4.01(e),
5-21 Medical Liability and Insurance Improvement Act of Texas (Article
5-22 4590i, Vernon's Texas Civil Statutes); [or]
5-23 (19) to comply with a court order except as provided
5-24 by Subdivision (20); or
5-25 (20) related to a judicial proceeding in which the
6-1 patient is a party and the disclosure is requested under a subpoena
6-2 issued under:
6-3 (A) the Texas Rules of Civil Procedure or Code
6-4 of Criminal Procedure; or
6-5 (B) Chapter 121, Civil Practice and Remedies
6-6 Code
6-7 [(10) to a court pursuant to a court order or court
6-8 subpoena].
6-9 SECTION 4. Section 241.154, Health and Safety Code, is
6-10 amended to read as follows:
6-11 Sec. 241.154. REQUEST. (a) On receipt of a written
6-12 authorization from a patient or legally authorized representative
6-13 to examine or copy all or part of the patient's recorded health
6-14 care information, or for disclosures under Section 241.153 not
6-15 requiring written authorization, a hospital or its agent, as
6-16 promptly as required under the circumstances but not later than the
6-17 15th day after the date the request and payment authorized under
6-18 Subsection (b) are [is] received, shall:
6-19 (1) make the information available for examination
6-20 during regular business hours and provide a copy to the requestor,
6-21 if requested; or
6-22 (2) inform the authorized requestor if the information
6-23 does not exist or cannot be found.
6-24 (b) Except as provided by Subsection (d), the [The] hospital
6-25 or its agent may charge a reasonable fee for providing the health
7-1 care information and is not required to permit the examination,
7-2 [or] copying, or release of the information requested until the fee
7-3 is paid unless there is a medical emergency. The fee may not
7-4 exceed the sum of:
7-5 (1) a basic retrieval or processing fee, which must
7-6 include the fee for providing the first 10 pages of the copies and
7-7 which may not exceed $30; and
7-8 (A) a charge for each page of:
7-9 (i) $1 for the 11th through the 60th page
7-10 of the provided copies;
7-11 (ii) 50 cents for the 61st through the
7-12 400th page of the provided copies; and
7-13 (iii) 25 cents for any remaining pages of
7-14 the provided copies; and
7-15 (B) the actual cost of mailing, shipping, or
7-16 otherwise delivering the provided copies; or
7-17 (2) if the requested records are stored on any
7-18 microform or other electronic medium [microfiche], a retrieval or
7-19 processing fee, which must include the fee for providing the first
7-20 10 pages of the copies and which may not exceed $45; and
7-21 (A) $1 per page thereafter; and
7-22 (B) the actual cost of mailing, shipping, or
7-23 otherwise delivering the provided copies.
7-24 (c) In addition, the hospital or its agent may charge a
7-25 reasonable fee for:
8-1 (1) execution of an affidavit or certification of a
8-2 document, not to exceed the charge authorized by Section 22.004,
8-3 Civil Practice and Remedies Code; and
8-4 (2) written responses to a written set of questions,
8-5 not to exceed $10 for a set.
8-6 (d) A hospital may not charge a fee for:
8-7 (1) providing health care information under Subsection
8-8 (b) to the extent the fee is prohibited under Subchapter M, Chapter
8-9 161;
8-10 (2) a patient to examine the patient's own health care
8-11 information;
8-12 (3) providing an itemized statement of billed services
8-13 to a patient or third-party payor, except as provided under Section
8-14 311.002(e); or
8-15 (4) health care information relating to treatment or
8-16 hospitalization for which workers' compensation benefits are being
8-17 sought, except to the extent permitted under Chapter 408, Labor
8-18 Code.
8-19 (e) Effective September 1, 1996, and annually thereafter,
8-20 the fee for providing health care information as specified in this
8-21 section shall be adjusted accordingly based on the most recent
8-22 changes to the consumer price index as published by the Bureau of
8-23 Labor Statistics of the United States Department of Labor that
8-24 measures the average changes in prices of goods and services
8-25 purchased by urban wage earners and clerical workers' families and
9-1 single workers living alone.
9-2 SECTION 5. Subsection (g), Section 241.152, Health and
9-3 Safety Code, is repealed.
9-4 SECTION 6. The importance of this legislation and the
9-5 crowded condition of the calendars in both houses create an
9-6 emergency and an imperative public necessity that the
9-7 constitutional rule requiring bills to be read on three several
9-8 days in each house be suspended, and this rule is hereby suspended.