By: Sibley S.R. No. 981 SENATE RESOLUTION 1-1 BE IT RESOLVED by the Senate of the State of Texas, 75th 1-2 Legislature, Regular Session, 1997, That Senate Rule 12.03 be 1-3 suspended in part as provided by Senate Rule 12.08 to enable the 1-4 conference committee appointed to resolve the differences on Senate 1-5 Bill No. 385 to consider and take action on the following specific 1-6 matters: 1-7 Senate Rules 12.03(2) and (3) are suspended to permit the 1-8 committee to change Subdivision (4) and add Subdivisions (5) 1-9 through (10) to Subsection (e), Article 1.35A, Insurance Code, to 1-10 read as 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 2-1 make public confidential information provided to the office under 2-2 this subsection but may disclose a summary of the information that 2-3 does not directly or indirectly identify the health maintenance 2-4 organization that is the subject of the information. The office of 2-5 public insurance counsel may not release, and a person or entity 2-6 may not gain access to, any information that: 2-7 (A) could reasonably be expected to reveal the 2-8 identity of a patient or physician or that reveals the zip code of 2-9 a patient's primary residence; 2-10 (B) discloses provider discounts or 2-11 differentials between payments and billed charges; or 2-12 (C) relates to actual payments to an identified 2-13 provider made by a payer. 2-14 (7) Information collected or used by the office of 2-15 public insurance counsel under this subsection is subject to the 2-16 confidentiality provisions and criminal penalties of: 2-17 (A) Section 81.103, Health and Safety Code; 2-18 (B) Section 311.037, Health and Safety Code; and 2-19 (C) Section 5.08, Medical Practice Act (Article 2-20 4495b, Vernon's Texas Civil Statutes). 2-21 (8) Information that is in the possession of the 2-22 office of public insurance counsel and that relates to patients and 2-23 physicians and any compilation, report, or analysis produced from 2-24 the information that identifies patients and physicians are not: 2-25 (A) subject to discovery, subpoena, or other 3-1 means of legal compulsion for release to any person or entity; or 3-2 (B) admissible in any civil, administrative, or 3-3 criminal proceeding. 3-4 (9) Notwithstanding Subdivision (6)(A) of this 3-5 subsection, the office of public insurance counsel may use zip code 3-6 information to analyze information on a geographic basis. 3-7 (10) The office may not endorse or recommend a 3-8 specific health maintenance organization or plan, or subjectively 3-9 rate or rank such organizations or plans, other than through 3-10 comparison and evaluation of objective criteria. 3-11 Explanation: These changes are necessary to provide adequate 3-12 confidentiality provisions to protect information reviewed by the 3-13 office of public insurance counsel and to ensure that evaluations 3-14 and comparisons of health maintenance organizations are done on a 3-15 fair and objective basis. 3-16 ______________________________________ 3-17 President of the Senate 3-18 I hereby certify that the above 3-19 Resolution was adopted by the Senate 3-20 on May 31, 1997, by the following vote: 3-21 Yeas 30, Nays 0. 3-22 ______________________________________ 3-23 Secretary of the Senate