SRC-DBM, JXG C.S.H.B. 2171 76(R)BILL ANALYSIS


Senate Research CenterC.S.H.B. 2171
By: Luna, Vilma (Truan)
Health Services
5/12/1999
Committee Report (Substituted)


DIGEST 

Currently, the law authorizes certain health care entities to form a
medical peer review committee or a medical committee to evaluate the
medical or health-care services provided by each respective entity.
However, the law does not grant the same authority to a hospital district
that has contracted out its medical or health care services.  In 1996, the
Nueces County Hospital District leased its hospital and three clinics to
Spohn Health System, a local Catholic healthcare system.  The hospital
district separately contracted with the Spohn System to furnish medical aid
and hospital care to indigent and needy persons within the hospital
district's boundaries.  As a result of the hospital district leasing its
hospital, the law no longer authorizes it to evaluate medical and
health-care services through a medical peer review committee or a medical
committee.  C.S.H.B. 2171 would set forth provisions for the establishment
and operation of a medical committee or medical peer review committee by
certain public and private entities. 

PURPOSE

As proposed, C.S.H.B. 2171 sets forth provisions for the establishment and
operation of a medical committee or medical peer review committee by
certain public and private entities. 

RULEMAKING AUTHORITY

This bill does not grant any additional rulemaking authority to a state
officer, institution, or agency. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 1.03(a) (5), Article 4495b, V.T.C.S. (Medical
Practice Act), to redefine "health-care entity." 

SECTION 2.  Amends Section 5.06, Article 4495b, V.T.C.S., by adding
Subsection (v), to provide that this section does not impose liability or
waive immunity for a hospital district or hospital authority that has
common-law, statutory, or other immunity. 

SECTION 3.  Amends Section 161.031(a), Health and Safety Code, to redefine
"medical committee." 

SECTION 4.  Amends Sections 161.032(a) and (c), Health and Safety Code, to
provide that a proceeding of a medical peer review committee, as defined by
Section 1.03, Article 4495b, V.T.C.S., or medical committee or a meeting of
the governing body of a public hospital, hospital district, or hospital
authority at which the governing body receives records, information,  or
reports provided by a medical committee or medical peer review committee is
not subject to Chapter 551, Government Code.  Provides that records,
information, or reports of a medical committee or medical peer review
committee and records, information, or reports provided by a medical
committee or medical peer review committee to the governing body of a
public hospital, hospital district, or hospital authority are not subject
to disclosure under Chapter 552, Government Code.  Provides that this
section and Section 5.06, Article 4495b, V.T.C.S., do not apply to records
made or maintained in the regular course of business by a hospital, health
maintenance organization, medical organization, university medical center
or health sciences center, hospital district, hospital authority, or
extended care facility. 

 SECTION 5.Amends the subchapter heading of Chapter 161D, Health and Safety
Code, as follows: 

SUBCHAPTER D.  New heading:  MEDICAL COMMITTEES AND MEDICAL PEER REVIEW
COMMITTEES 

SECTION 6.  Amends Chapter 161D, Health and Safety Code, by adding Section
161.0315, as follows: 

Sec. 161.0315.  AUTHORITY OF GOVERNING BODY TO FORM COMMITTEE TO EVALUATE
MEDICAL AND HEALTH-CARE SERVICES.  (a) Authorizes a governing body of a
hospital, medical organization, university medical school or health science
center, health maintenance organization, extended care facility, hospital
district, or hospital authority to form a medical peer review committee, as
defined by Section 1.03, Article 4495b, V.T.C.S., or a medical committee,
as defined by Section 161.031, to evaluate medical and health-care
services, except as provided by this section.   

(b) Prohibits a medical peer review committee or medical committee formed
by the governing body of a hospital district from evaluating medical and
health care services provided by a health care facility that contracts with
the district to provide those services, and has formed a medical peer
review committee or medical committee to evaluate the services provided by
the facility, except as provided by Subsection (d).   

(c) Authorizes a hospital district to require in a contract with a health
care facility described by Subsection (b), a provision that allows the
governing body of the hospital district to appoint a specified number of
members to the facility's medical peer review committee or medical
committee to evaluate medical and health care services for which the
district contracts with the facility to provide.  Authorizes the governing
body of a hospital district to receive a report from the facility's medical
peer review committee or medical committee under this section in a closed
meeting.  Provides that a report, information, or a record that the
district receives from the facility related to a review action conducted is
subject to certain terms.   

(d) Sets forth the rights of the hospital district, if a hospital and
health care facility do not agree. 

(e) Authorizes the governing body of a hospital district to receive a
report under Subsection (d)(3) in a closed meeting.   Provides that a
report, information, or a record that the hospital district receives is
subject to certain terms.   

SECTION 7.Emergency clause.
  Effective date: upon passage.