1-1 AN ACT
1-2 relating to the establishment and operation of a medical committee
1-3 or medical peer review committee by certain public and private
1-4 entities.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. Section 1.03(a)(5), Medical Practice Act (Article
1-7 4495b, Vernon's Texas Civil Statutes), is amended to read as
1-8 follows:
1-9 (5) "Health-care entity" means:
1-10 (A) a hospital that is licensed pursuant to
1-11 Chapter 241 or 577, Health and Safety Code [or the Texas Mental
1-12 Health Code (Articles 5547-88 through 5547-100, Vernon's Texas
1-13 Civil Statutes)];
1-14 (B) an entity, including a health maintenance
1-15 organization, group medical practice, nursing home, health science
1-16 center, university medical school, hospital district, hospital
1-17 authority, or other health-care facility, that provides or pays for
1-18 medical or health-care services and that follows a formal peer
1-19 review process for the purposes of furthering quality medical or
1-20 health care;
1-21 (C) a professional society or association, or
1-22 committee thereof, of physicians that follows a formal peer review
1-23 process for the purpose of furthering quality medical or health
1-24 care; and
2-1 (D) an organization established by a
2-2 professional society or association of physicians or of hospitals,
2-3 or both, that collects and verifies the authenticity of documents
2-4 and other data concerning the qualifications, competence, or
2-5 performance of licensed health care professionals and that acts as
2-6 a health care facility's agent pursuant to the Health Care Quality
2-7 Improvement Act of 1986, Title IV, Pub. L. 99-660 (42 U.S.C.
2-8 Section 11101 et seq.).
2-9 SECTION 2. Section 5.06, Medical Practice Act (Article
2-10 4495b, Vernon's Texas Civil Statutes), is amended by adding
2-11 Subsection (v) to read as follows:
2-12 (v) This section does not impose liability or waive immunity
2-13 for a hospital district or hospital authority that has common-law,
2-14 statutory, or other immunity.
2-15 SECTION 3. Section 161.031(a), Health and Safety Code, is
2-16 amended to read as follows:
2-17 (a) In this subchapter, "medical committee" includes any
2-18 committee, including a joint committee, of:
2-19 (1) a hospital;
2-20 (2) a medical organization;
2-21 (3) a university medical school or health science
2-22 center;
2-23 (4) a health maintenance organization licensed under
2-24 the Texas Health Maintenance Organization Act (Chapter 20A,
2-25 Vernon's Texas Insurance Code), including an independent practice
2-26 association or other physician association whose committee or joint
2-27 committee is a condition of contract with the health maintenance
3-1 organization; [or]
3-2 (5) an extended care facility;
3-3 (6) a hospital district; or
3-4 (7) a hospital authority.
3-5 SECTION 4. Sections 161.032(a) and (c), Health and Safety
3-6 Code, are amended to read as follows:
3-7 (a) The records and proceedings of a medical committee are
3-8 confidential and are not subject to court subpoena. A proceeding
3-9 of a medical peer review committee, as defined by Section 1.03,
3-10 Medical Practice Act (Article 4495b, Vernon's Texas Civil
3-11 Statutes), or medical committee, or a meeting of the governing body
3-12 of a public hospital, hospital district, or hospital authority at
3-13 which the governing body receives records, information, or reports
3-14 provided by a medical committee or medical peer review committee is
3-15 not subject to Chapter 551, Government Code. Records, information,
3-16 or reports of a medical committee or medical peer review committee
3-17 and records, information, or reports provided by a medical
3-18 committee or medical peer review committee to the governing body of
3-19 a public hospital, hospital district, or hospital authority are not
3-20 subject to disclosure under Chapter 552, Government Code.
3-21 (c) This section and Section 5.06, Medical Practice
3-22 [Practices] Act (Article 4495b, Vernon's Texas Civil Statutes), do
3-23 not apply to records made or maintained in the regular course of
3-24 business by a hospital, health maintenance organization, medical
3-25 organization, university medical center or health science center,
3-26 hospital district, hospital authority, or extended care facility.
3-27 SECTION 5. The subchapter heading of Subchapter D, Chapter
4-1 161, Health and Safety Code, is amended to read as follows:
4-2 SUBCHAPTER D. [RECORDS OF AND IMMUNITIES FOR]
4-3 MEDICAL COMMITTEES AND MEDICAL PEER REVIEW COMMITTEES
4-4 SECTION 6. Subchapter D, Chapter 161, Health and Safety
4-5 Code, is amended by adding Section 161.0315 to read as follows:
4-6 Sec. 161.0315. AUTHORITY OF GOVERNING BODY TO FORM COMMITTEE
4-7 TO EVALUATE MEDICAL AND HEALTH CARE SERVICES. (a) The governing
4-8 body of a hospital, medical organization, university medical school
4-9 or health science center, health maintenance organization, extended
4-10 care facility, hospital district, or hospital authority may form a
4-11 medical peer review committee, as defined by Section 1.03, Medical
4-12 Practice Act (Article 4495b, Vernon's Texas Civil Statutes), or a
4-13 medical committee, as defined by Section 161.031, to evaluate
4-14 medical and health care services, except as provided by this
4-15 section.
4-16 (b) Except as provided by Subsection (d), a medical peer
4-17 review committee or medical committee formed by the governing body
4-18 of a hospital district may not evaluate medical and health care
4-19 services provided by a health care facility that:
4-20 (1) contracts with the district to provide those
4-21 services; and
4-22 (2) has formed a medical peer review committee or
4-23 medical committee to evaluate the services provided by the
4-24 facility.
4-25 (c) A hospital district may require in a contract with a
4-26 health care facility described by Subsection (b) a provision that
4-27 allows the governing body of the district to appoint a specified
5-1 number of members to the facility's medical peer review committee
5-2 or medical committee to evaluate medical and health care services
5-3 for which the district contracts with the facility to provide. The
5-4 governing body of a hospital district may receive a report from the
5-5 facility's medical peer review committee or medical committee under
5-6 this section in a closed meeting. A report, information, or a
5-7 record that the district receives from the facility related to a
5-8 review action conducted under the terms of the contract is:
5-9 (1) confidential;
5-10 (2) not subject to disclosure under Chapter 552,
5-11 Government Code; and
5-12 (3) subject to the same confidentiality and disclosure
5-13 requirements to which a report, information, or record of a medical
5-14 peer review committee under Section 5.06(s), Medical Practice Act
5-15 (Article 4495b, Vernon's Texas Civil Statutes), is subject.
5-16 (d) If a hospital district and a health care facility
5-17 described by Subsection (b) do not agree on a contract provision
5-18 described by Subsection (c), the hospital district has, with
5-19 respect to a review action for the evaluation of medical and health
5-20 care services provided by the facility under a contract with the
5-21 district, a right to:
5-22 (1) initiate the review action;
5-23 (2) appoint from the medical staff of the facility a
5-24 number of members to the facility's medical peer review committee
5-25 or medical committee equal to the number of members appointed to
5-26 the committee by the facility to conduct the review action,
5-27 without regard to whether the district initiates the action; and
6-1 (3) receive records, information, or reports from the
6-2 medical peer review committee or medical committee related to the
6-3 review action.
6-4 (e) The governing body of a hospital district may receive a
6-5 report under Subsection (d)(3) in a closed meeting. A report,
6-6 information, or a record that the hospital district receives under
6-7 Subsection (d)(3) is:
6-8 (1) confidential;
6-9 (2) not subject to disclosure under Chapter 552,
6-10 Government Code; and
6-11 (3) subject to the same confidentiality and disclosure
6-12 requirements to which a report, information, or record of a medical
6-13 peer review committee under Section 5.06(s), Medical Practice Act
6-14 (Article 4495b, Vernon's Texas Civil Statutes), is subject.
6-15 SECTION 7. The importance of this legislation and the
6-16 crowded condition of the calendars in both houses create an
6-17 emergency and an imperative public necessity that the
6-18 constitutional rule requiring bills to be read on three several
6-19 days in each house be suspended, and this rule is hereby suspended,
6-20 and that this Act take effect and be in force from and after its
6-21 passage, and it is so enacted.
_______________________________ _______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 2171 was passed by the House on April
23, 1999, by the following vote: Yeas 141, Nays 0, 2 present, not
voting; and that the House concurred in Senate amendments to H.B.
No. 2171 on May 21, 1999, by the following vote: Yeas 142, Nays 0,
1 present, not voting.
_______________________________
Chief Clerk of the House
I certify that H.B. No. 2171 was passed by the Senate, with
amendments, on May 19, 1999, by the following vote: Yeas 29, Nays
0.
_______________________________
Secretary of the Senate
APPROVED: _____________________
Date
_____________________
Governor