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