By Maxey H.B. No. 1513
76R1446 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.
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
2-1 committee with respect to other formal action of the council. A
2-2 technical advisory committee may consult with other professionals
2-3 as necessary. Chapter 2110, Government Code, does not apply to an
2-4 advisory committee appointed under this section. The technical
2-5 advisory committees shall include:
2-6 (1) a technical advisory committee [that includes,
2-7 among other individuals, at least five practicing physicians
2-8 licensed in this state] to provide advice and recommendations to
2-9 the council on[:]
2-10 [(A)] the development and implementation of the
2-11 methodology and the interpretation of provider quality data under
2-12 Section 108.010; [and]
2-13 [(B) the development and dissemination of
2-14 consumer education information and materials;]
2-15 (2) a technical advisory committee composed of [at
2-16 least five practicing] physicians licensed in this state who have
2-17 been actively engaged in organized peer review at a hospital in
2-18 this state to provide advice, recommendations, and peer review
2-19 expertise to the council on:
2-20 (A) the use of peer review in the determination
2-21 of quality inpatient care;
2-22 (B) the development and interpretation of data
2-23 elements necessary to the determination of quality inpatient care;
2-24 and
2-25 (C) the development and format of reports and
2-26 information relating to provider quality;
2-27 (3) [a technical advisory committee 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 composed of
3-4 representatives of each type of issuer of health benefit plans to
3-5 assist the council in complying with Section 108.009(o); and
3-6 (4) [(5)] a technical advisory committee composed of
3-7 individuals who have expertise in hospital information systems,
3-8 health information management, and quality management.
3-9 SECTION 3. Section 108.0045, Health and Safety Code, is
3-10 amended to read as follows:
3-11 Sec. 108.0045. OPEN RECORDS. (a) Subject to the
3-12 restrictions of this chapter, the council is subject to the open
3-13 records law, Chapter 552, Government Code.
3-14 (b) The council may not produce public information for
3-15 inspection or duplication before the 20th business day after the
3-16 date the information is requested. Before the council produces the
3-17 public information, the council shall verify the accuracy of the
3-18 information.
3-19 SECTION 4. Section 108.009, Health and Safety Code, is
3-20 amended by adding Subsection (j) to read as follows:
3-21 (j) The commission may charge a provider or a health benefit
3-22 plan a fee for any incorrect data that the provider or health
3-23 benefit plan submits. Fees collected under this subsection shall
3-24 be deposited in the general revenue fund to the credit of the
3-25 health care information account. Money in the account may be
3-26 appropriated only to the council to enforce this chapter.
3-27 SECTION 5. Section 108.010(i), Health and Safety Code, is
4-1 amended to read as follows:
4-2 (i) The council shall release provider quality data relating
4-3 to providers described by Section 108.0025(1)[, but that are not
4-4 rural providers because they do not meet the requirement of Section
4-5 108.0025(2),] in an aggregate form without uniform [patient and]
4-6 physician identifiers.
4-7 SECTION 6. Section 108.011(i), Health and Safety Code, is
4-8 amended to read as follows:
4-9 (i) The council shall release public use data relating to
4-10 providers described by Section 108.0025(1)[, but that are not rural
4-11 providers because they do not meet the requirement of Section
4-12 108.0025(2),] in an aggregate form without uniform [patient and]
4-13 physician identifiers.
4-14 SECTION 7. Sections 108.013(c), (e), (f), (g), and (h),
4-15 Health and Safety Code, are amended to read as follows:
4-16 (c) Unless specifically authorized by this chapter, the
4-17 council may not release and a person or entity may not gain access
4-18 to any data:
4-19 (1) that could reasonably be expected to reveal the
4-20 identity of a patient [or physician or that reveals the zip code of
4-21 a patient's primary residence];
4-22 (2) that could reasonably be expected to reveal the
4-23 identity of a physician;
4-24 (3) disclosing provider discounts or differentials
4-25 between payments and billed charges; or
4-26 (4) [(3)] relating to actual payments to an identified
4-27 provider made by a payer.
5-1 (e) Data on patients [and physicians] and compilations
5-2 produced from the data collected that identify patients [and
5-3 physicians] are not:
5-4 (1) subject to discovery, subpoena, or other means of
5-5 legal compulsion for release to any person or entity except as
5-6 provided by this section; or
5-7 (2) admissible in any civil, administrative, or
5-8 criminal proceeding.
5-9 (f) Data on physicians and compilations produced from the
5-10 data collected that identify physicians are not:
5-11 (1) subject to discovery, subpoena, or other means of
5-12 legal compulsion for release to any person or entity except as
5-13 provided by this section; or
5-14 (2) admissible in any civil, administrative, or
5-15 criminal proceeding [Notwithstanding Subsection (c)(1), the council
5-16 may use zip code information to analyze data on a geographic
5-17 basis].
5-18 (g) The council may not release data elements in a manner
5-19 that will reveal the identity of a [physician or] patient. The
5-20 council may not release data elements in a manner that will reveal
5-21 the identity of a physician.
5-22 (h) Subsections [Subsection] (c)[(1)] and [Subsection] (g)
5-23 do not prohibit the release of a uniform physician identifier [or a
5-24 uniform patient identifier] in conjunction with associated public
5-25 use data in accordance with Section 108.011 or provider quality
5-26 data in accordance with Section 108.010.
5-27 SECTION 8. Chapter 108, Health and Safety Code, is amended
6-1 by adding Section 108.0135 to read as follows:
6-2 Sec. 108.0135. RELEASE OF INFORMATION. (a) The council
6-3 shall establish a committee to approve requests for information.
6-4 The members of the committee shall have experience in ethics,
6-5 patient confidentiality, and health care data.
6-6 (b) To assist the committee in determining whether to
6-7 approve a request for information, the council shall adopt rules
6-8 similar to the federal Health Care Financing Administration's
6-9 guidelines on releasing data.
6-10 (c) A request for information must be made on the form
6-11 created by the council.
6-12 SECTION 9. Section 108.014, Health and Safety Code, is
6-13 amended by amending Subsection (c) and adding Subsection (d) to
6-14 read as follows:
6-15 (c) The attorney general, at the request of the council,
6-16 shall enforce this chapter. The venue of an action brought under
6-17 this section is in Travis County.
6-18 (d) A civil penalty recovered in a suit instituted by the
6-19 attorney general under this chapter shall be deposited in the
6-20 general revenue fund to the credit of the health care information
6-21 account.
6-22 SECTION 10. Chapter 108, Health and Safety Code, is amended
6-23 by adding Section 108.0142 to read as follows:
6-24 Sec. 108.0142. RELEASE OF LIABILITY. Notwithstanding any
6-25 other law, a provider or health benefit plan that submits data to
6-26 the council under this chapter is not liable to the extent that the
6-27 release of information violates another law.
7-1 SECTION 11. This Act takes effect September 1, 1999.
7-2 SECTION 12. The importance of this legislation and the
7-3 crowded condition of the calendars in both houses create an
7-4 emergency and an imperative public necessity that the
7-5 constitutional rule requiring bills to be read on three several
7-6 days in each house be suspended, and this rule is hereby suspended.