SRC-ARR C.S.S.B. 1591 76(R)BILL ANALYSIS


Senate Research CenterC.S.S.B. 1591
76R12719 JRD-FBy: Zaffirini
Human Services
4/28/1999
Committee Report (Substituted)


DIGEST 

The Texas Performance Review recommended that Texas implement national
electronic interchange standards for health care claims and streamline
health care data reporting and  processing. Due to widespread frustration
regarding health care claims payments, Congress in 1996 passed legislation
that will require claims payers to support electronic claims processing
using national electronic data interchange (EDI) standards. C.S.S.B. 1591
would require the implementation of national standards for the electronic
processing of health care and health payment information. 

PURPOSE

As proposed, C.S.S.B. 1591 requires the implementation of national
standards for the electronic processing of health care and health payment
information. 

RULEMAKING AUTHORITY

Rulemaking authority is granted to the Health and Human Services Commission
in SECTION 2 (Section 532.002(c), Government Code) of this bill 

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Chapter 531B, Government Code, by adding Sections
531.0315 and 531.0316, as follows:  

Sec. 531.0315. IMPLEMENTING NATIONAL ELECTRONIC DATA INTERCHANGE STANDARDS
FOR HEALTH CARE INFORMATION. Requires each health and human services agency
and every other state agency that acts as a health care provider or a
claims payer for the provision of health care to take certain actions.
Provides that this section does not prohibit a state agency from seeking a
federal waiver from compliance under applicable federal law. 

Sec. 531.0316. HEALTH CLAIMS INFORMATION ON INTERNET. Requires the Health
and Human Service Commission (commission) and the Texas Health Care
Information Council (council) to develop a plan to make information about
claims for the provision of health care that are paid with state money and
information about other claims for the provision of health care that is
collected by the state available through the Internet, to the extent that
the information is not identifiable to any individual. Requires the
commission and the council to submit the plan to the presiding officers of
each house of the legislature not later than November 1, 2000. Provides
that this section expires September 1, 2001. 

SECTION 2. Amends Section 532.002, Government Code, by adding Subsection
(c), to require the commission to require, by rule, that each contract to
carry out the purpose of this chapter, whether entered into by the
commission, by a health and human services agency acting under Section
532.004, or by an intergovernmental initiative, to require any contractor
that will create, maintain, or process information related to the provision
of or payment for health care to comply in a timely manner with the
national data interchange standards adopted under Title IIF, Health
Insurance Portability and Accountability Act. 

SECTION 3. Amends Section 109.061, Health and Safety Code, by adding
Subsection (j), to require  the corporation to require eligible coverage to
comply in a timely manner, in connection with the program, with the
national data interchange standards adopted under Title IIF, Health
Insurance Portability and Accountability Act. 

SECTION 4. Sets forth the establishment of the National Data Interchange
Standards Task Force (task force). Provides that the task force is composed
of the administrative heads of certain state offices and agencies. Provides
that the representative of the commission is the presiding officer of the
task force. Requires the commission to direct the analyses required under
this section. Authorizes the staff of each office and agency represented on
the task force to assist the task force in performing its duties. Requires
the task force to periodically report the results and conclusions of its
analyses and recommend needed legislation to the legislature. Provides that
the task force is abolished September 1, 2005.  

SECTION 5. Emergency clause.
                      Effective date: upon passage.

SUMMARY OF COMMITTEE CHANGES

SECTION 1. 

Amends Chapter 531B, rather than Chapter 2054C, Government Code, by
amending Section 531.0315, Government Code, rather than Section 2054.0542,
to require each health and human services agency and every other state
agency that acts as a health care provider or a claims payer for the
provision of health care to take certain actions. Provides that this
section does not prohibit a state agency from seeking a federal waiver from
compliance under applicable federal law.  

Amends Section 531.0316, Government Code, rather than Section 2054.0543, to
require the commission, rather than the Department of Information Resources
(department), and council to develop a certain plan. 

SECTION 4. 

Amends SECTION 4 to provide that the task force is composed of the
administrative heads of certain state offices and agencies, including the
State Office of Risk Management. Provides that the representative of the
commission, rather than the department, is the presiding officer of the
task force. Requires the commission, rather than the department,  to direct
the analyses required under this section.