76R10569 MCK-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to powers and duties of the Texas Health Care Information
1-3 Council; providing a criminal penalty.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Section 108.002(14), Health and Safety Code, is
1-6 amended to read as follows:
1-7 (14) "Public use data" means patient level data
1-8 relating to individual hospitalizations that has not been
1-9 summarized or analyzed, that has had patient identifying
1-10 information removed, that identifies [patients and] physicians only
1-11 by use of uniform [patient and] physician identifiers, and that is
1-12 severity and risk adjusted and verified for accuracy.
1-13 SECTION 2. Section 108.003(g), Health and Safety Code, is
1-14 amended to read as follows:
1-15 (g) The council shall appoint technical advisory committees
1-16 and shall consult with the appropriate technical advisory committee
1-17 with respect to a rule before the rule is finally adopted by the
1-18 council. The council is not required to consult with a technical
1-19 advisory committee before adopting an emergency rule in accordance
1-20 with Section 2001.034, Government Code. The council shall submit
1-21 an emergency rule adopted by the council to the appropriate
1-22 advisory committee for review not later than the first advisory
1-23 committee meeting that occurs after the rule is adopted. The
1-24 council may consult with the appropriate technical advisory
1-25 committee with respect to other formal action of the council. A
1-26 technical advisory committee may consult with other professionals
1-27 as necessary. Chapter 2110, Government Code, does not apply to an
2-1 advisory committee appointed under this section. The technical
2-2 advisory committees shall include:
2-3 (1) a technical advisory committee that includes,
2-4 among other individuals, at least five practicing physicians
2-5 licensed in this state to provide advice and recommendations to the
2-6 council on[:]
2-7 [(A)] the development and implementation of the
2-8 methodology and the interpretation of a provider quality report and
2-9 data under Section 108.010; [and]
2-10 [(B) the development and dissemination of
2-11 consumer education information and materials;]
2-12 (2) a technical advisory committee composed of at
2-13 least five practicing physicians licensed in this state who have
2-14 been actively engaged in organized peer review at a hospital in
2-15 this state to provide advice, recommendations, and peer review
2-16 expertise to the council on:
2-17 (A) the use of peer review in the determination
2-18 of quality inpatient care;
2-19 (B) the development and interpretation of data
2-20 elements necessary to the determination of quality inpatient care;
2-21 and
2-22 (C) the development and format of reports and
2-23 information relating to provider quality;
2-24 (3) a technical advisory committee that includes
2-25 providers and consumers to provide advice and recommendations to
2-26 the council relating to education about the development and
2-27 dissemination of the provider quality report and data [composed of
3-1 individuals who have expertise in the reimbursement of medical
3-2 education and research costs];
3-3 (4) a technical advisory committee that includes
3-4 [composed of] representatives of consumers and each type of issuer
3-5 of health benefit plans to assist the council in complying with
3-6 Section 108.009(o); and
3-7 (5) a technical advisory committee composed of
3-8 providers, consumers, and individuals who have expertise in
3-9 hospital information systems, health information management, [and]
3-10 quality management, and security of confidential data.
3-11 SECTION 3. Section 108.010(i), Health and Safety Code, is
3-12 amended to read as follows:
3-13 (i) The council shall release provider quality data
3-14 [relating to providers described by Section 108.0025(1), but that
3-15 are not rural providers because they do not meet the requirement of
3-16 Section 108.0025(2),] in an aggregate form without uniform [patient
3-17 and] physician identifiers when:
3-18 (1) the data relates to providers described by Section
3-19 108.0025(1); or
3-20 (2) the cell size of the data is below the minimum
3-21 size established by council rule that would enable identification
3-22 of an individual patient.
3-23 SECTION 4. Section 108.011(i), Health and Safety Code, is
3-24 amended to read as follows:
3-25 (i) The council shall release public use data [relating to
3-26 providers described by Section 108.0025(1), but that are not rural
3-27 providers because they do not meet the requirement of Section
4-1 108.0025(2),] in an aggregate form without uniform [patient and]
4-2 physician identifiers when:
4-3 (1) the data relates to providers described by Section
4-4 108.0025(1); or
4-5 (2) the cell size of the data is below the minimum
4-6 size established by council rule that would enable identification
4-7 of an individual patient.
4-8 SECTION 5. Section 108.013, Health and Safety Code, is
4-9 amended by amending Subsections (c), (e), (f), (g), and (h) and
4-10 adding Subsection (j) to read as follows:
4-11 (c) Unless specifically authorized by this chapter, the
4-12 council may not release and a person or entity may not gain access
4-13 to any data:
4-14 (1) that could reasonably be expected to reveal the
4-15 identity of a patient [or physician or that reveals the zip code of
4-16 a patient's primary residence];
4-17 (2) that could reasonably be expected to reveal the
4-18 identity of a physician;
4-19 (3) disclosing provider discounts or differentials
4-20 between payments and billed charges; or
4-21 (4) [(3)] relating to actual payments to an identified
4-22 provider made by a payer.
4-23 (e) Data on patients [and physicians] and compilations
4-24 produced from the data collected that identify patients [and
4-25 physicians] are not:
4-26 (1) subject to discovery, subpoena, or other means of
4-27 legal compulsion for release to any person or entity except as
5-1 provided by this section; or
5-2 (2) admissible in any civil, administrative, or
5-3 criminal proceeding.
5-4 (f) Data on physicians and compilations produced from the
5-5 data collected that identify physicians are not:
5-6 (1) subject to discovery, subpoena, or other means of
5-7 legal compulsion for release to any person or entity except as
5-8 provided by this section; or
5-9 (2) admissible in any civil, administrative, or
5-10 criminal proceeding. [Notwithstanding Subsection (c)(1), the
5-11 council may use zip code information to analyze data on a
5-12 geographic basis.]
5-13 (g) The council may not release data elements in a manner
5-14 that will reveal the identity of a [physician or] patient. The
5-15 council may not release data elements in a manner that will reveal
5-16 the identity of a physician.
5-17 (h) Subsections (c) [Subsection (c)(1)] and [Subsection] (g)
5-18 do not prohibit the release of a uniform physician identifier [or a
5-19 uniform patient identifier] in conjunction with associated public
5-20 use data in accordance with Section 108.011 or a provider quality
5-21 report [data] in accordance with Section 108.010.
5-22 (j) The council shall by rule, with the assistance of the
5-23 advisory committee under Section 108.003(g)(5), develop and
5-24 implement a mechanism to comply with Subsections (c)(1) and (2).
5-25 SECTION 6. Chapter 108, Health and Safety Code, is amended
5-26 by adding Section 108.0135 to read as follows:
5-27 Sec. 108.0135. SCIENTIFIC REVIEW PANEL. (a) The council
6-1 shall establish a scientific review panel to review and approve
6-2 requests for information other than public use data. The members of
6-3 the panel shall have experience and expertise in ethics, patient
6-4 confidentiality, and health care data.
6-5 (b) To assist the panel in determining whether to approve a
6-6 request for information, the council shall adopt rules similar to
6-7 the federal Health Care Financing Administration's guidelines on
6-8 releasing data.
6-9 (c) A request for information other than public use data
6-10 must be made on the form created by the council.
6-11 SECTION 7. Section 108.014, Health and Safety Code, is
6-12 amended by amending Subsection (c) and adding Subsection (d) to
6-13 read as follows:
6-14 (c) The attorney general, at the request of the council,
6-15 shall enforce this chapter. The venue of an action brought under
6-16 this section is in Travis County.
6-17 (d) A civil penalty recovered in a suit instituted by the
6-18 attorney general under this chapter shall be deposited in the
6-19 general revenue fund to the credit of the health care information
6-20 account.
6-21 SECTION 8. Section 108.0141, Health and Safety Code, is
6-22 amended to read as follows:
6-23 Sec. 108.0141. CRIMINAL PENALTY. (a) A person who
6-24 knowingly accesses data in violation of this chapter or who with
6-25 criminal negligence releases data in violation of this chapter
6-26 commits an offense.
6-27 (b) An offense under this section is a state jail felony
7-1 [Class A misdemeanor].
7-2 SECTION 9. Chapter 108, Health and Safety Code, is amended
7-3 by adding Sections 108.0142 and 108.0143 to read as follows:
7-4 Sec. 108.0142. CIVIL CAUSE OF ACTION FOR IMPROPER ACCESS OR
7-5 DISCLOSURE. (a) A person who is injured by the accessing or
7-6 release of information in violation of this chapter has a civil
7-7 cause of action for damages against the person who accessed or
7-8 released the information in violation of this chapter.
7-9 (b) A plaintiff who prevails in a suit under this section
7-10 may recover:
7-11 (1) actual damages, including damages for mental
7-12 anguish even if an injury other than mental anguish is not shown;
7-13 (2) exemplary damages;
7-14 (3) court costs; and
7-15 (4) reasonable attorney's fees.
7-16 Sec. 108.0143. RELEASE OF LIABILITY. Notwithstanding any
7-17 other law, a provider or health benefit plan that submits data to
7-18 the council under this chapter is not liable to the extent that the
7-19 release of information violates another law.
7-20 SECTION 10. (a) This Act takes effect September 1, 1999.
7-21 (b) The Texas Health Care Information Council shall adopt
7-22 initial rules required by Section 108.013(j), Health and Safety
7-23 Code, as added by this Act, not later than January 1, 2000.
7-24 (c) The change in law made by this Act to Section 108.0141,
7-25 Health and Safety Code, applies only to an offense committed on or
7-26 after the effective date of this Act. An offense committed before
7-27 the effective date of this Act is covered by the law in effect when
8-1 the offense was committed, and the former law is continued in
8-2 effect for that purpose. For purposes of this section, an offense
8-3 was committed before the effective date of this Act if any element
8-4 of the offense occurred before that date.
8-5 SECTION 11. The importance of this legislation and the
8-6 crowded condition of the calendars in both houses create an
8-7 emergency and an imperative public necessity that the
8-8 constitutional rule requiring bills to be read on three several
8-9 days in each house be suspended, and this rule is hereby suspended.