1-1 By: Luna, Seaman, Capelo, et al. H.B. No. 2171
1-2 (Senate Sponsor - Truan)
1-3 (In the Senate - Received from the House April 26, 1999;
1-4 April 27, 1999, read first time and referred to Committee on Health
1-5 Services; May 13, 1999, reported adversely, with favorable
1-6 Committee Substitute by the following vote: Yeas 4, Nays 0;
1-7 May 13, 1999, sent to printer.)
1-8 COMMITTEE SUBSTITUTE FOR H.B. No. 2171 By: Moncrief
1-9 A BILL TO BE ENTITLED
1-10 AN ACT
1-11 relating to the establishment and operation of a medical committee
1-12 or medical peer review committee by certain public and private
1-13 entities.
1-14 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-15 SECTION 1. Section 1.03(a)(5), Medical Practice Act (Article
1-16 4495b, Vernon's Texas Civil Statutes), is amended to read as
1-17 follows:
1-18 (5) "Health-care entity" means:
1-19 (A) a hospital that is licensed pursuant to
1-20 Chapter 241 or 577, Health and Safety Code [or the Texas Mental
1-21 Health Code (Articles 5547-88 through 5547-100, Vernon's Texas
1-22 Civil Statutes)];
1-23 (B) an entity, including a health maintenance
1-24 organization, group medical practice, nursing home, health science
1-25 center, university medical school, hospital district, hospital
1-26 authority, or other health-care facility, that provides or pays for
1-27 medical or health-care services and that follows a formal peer
1-28 review process for the purposes of furthering quality medical or
1-29 health care;
1-30 (C) a professional society or association, or
1-31 committee thereof, of physicians that follows a formal peer review
1-32 process for the purpose of furthering quality medical or health
1-33 care; and
1-34 (D) an organization established by a
1-35 professional society or association of physicians or of hospitals,
1-36 or both, that collects and verifies the authenticity of documents
1-37 and other data concerning the qualifications, competence, or
1-38 performance of licensed health care professionals and that acts as
1-39 a health care facility's agent pursuant to the Health Care Quality
1-40 Improvement Act of 1986, Title IV, Pub. L. 99-660 (42 U.S.C.
1-41 Section 11101 et seq.).
1-42 SECTION 2. Section 5.06, Medical Practice Act (Article
1-43 4495b, Vernon's Texas Civil Statutes), is amended by adding
1-44 Subsection (v) to read as follows:
1-45 (v) This section does not impose liability or waive immunity
1-46 for a hospital district or hospital authority that has common-law,
1-47 statutory, or other immunity.
1-48 SECTION 3. Section 161.031(a), Health and Safety Code, is
1-49 amended to read as follows:
1-50 (a) In this subchapter, "medical committee" includes any
1-51 committee, including a joint committee, of:
1-52 (1) a hospital;
1-53 (2) a medical organization;
1-54 (3) a university medical school or health science
1-55 center;
1-56 (4) a health maintenance organization licensed under
1-57 the Texas Health Maintenance Organization Act (Chapter 20A,
1-58 Vernon's Texas Insurance Code), including an independent practice
1-59 association or other physician association whose committees or
1-60 joint committee is a condition of contract with the health
1-61 maintenance organization; [or]
1-62 (5) an extended care facility;
1-63 (6) a hospital district; or
1-64 (7) a hospital authority.
2-1 SECTION 4. Sections 161.032(a) and (c), Health and Safety
2-2 Code are amended to read as follows:
2-3 (a) The records and proceedings of a medical committee are
2-4 confidential and are not subject to court subpoena. A proceeding
2-5 of a medical peer review committee, as defined by Section 1.03,
2-6 Medical Practice Act (Article 4495b, Vernon's Texas Civil Statutes)
2-7 or medical committee, or a meeting of the governing body of a
2-8 public hospital, hospital district, or hospital authority at which
2-9 the governing body receives records, information, or reports
2-10 provided by a medical committee or medical peer review committee is
2-11 not subject to Chapter 551, Government Code. Records, information,
2-12 or reports of a medical committee or medical peer review committee
2-13 and records, information, or reports provided by a medical
2-14 committee or medical peer review committee to the governing body of
2-15 a public hospital, hospital district, or hospital authority are not
2-16 subject to disclosure under Chapter 552, Government Code.
2-17 (c) This section and Section 5.06, Medical Practice
2-18 [Practices] Act (Article 4495b, Vernon's Texas Civil Statutes), do
2-19 not apply to records made or maintained in the regular course of
2-20 business by a hospital, health maintenance organization, medical
2-21 organization, university medical center or health science center,
2-22 hospital district, hospital authority, or extended care facility.
2-23 SECTION 5. The subchapter heading of Subchapter D, Chapter
2-24 161, Health and Safety Code, is amended to read as follows:
2-25 SUBCHAPTER D. [RECORDS OF AND IMMUNITIES FOR]
2-26 MEDICAL COMMITTEES AND MEDICAL PEER REVIEW COMMITTEES
2-27 SECTION 6. Subchapter D, Chapter 161, Health and Safety
2-28 Code, is amended by adding Section 161.0315 to read as follows:
2-29 Sec. 161.0315. AUTHORITY OF GOVERNING BODY TO FORM COMMITTEE
2-30 TO EVALUATE MEDICAL AND HEALTH CARE SERVICES. (a) The governing
2-31 body of a hospital, medical organization, university medical school
2-32 or health science center, health maintenance organization, extended
2-33 care facility, hospital district, or hospital authority may form a
2-34 medical peer review committee, as defined by Section 1.03, Medical
2-35 Practice Act (Article 4495b, Vernon's Texas Civil Statutes), or a
2-36 medical committee, as defined by Section 161.031, to evaluate
2-37 medical and health care services, except as provided by this
2-38 section.
2-39 (b) Except as provided by Subsection (d), a medical peer
2-40 review committee or medical committee formed by the governing body
2-41 of a hospital district may not evaluate medical and health care
2-42 services provided by a health care facility that:
2-43 (1) contracts with the district to provide those
2-44 services; and
2-45 (2) has formed a medical peer review committee or
2-46 medical committee to evaluate the services provided by the
2-47 facility.
2-48 (c) A hospital district may require in a contract with a
2-49 health care facility described by subsection (b) a provision that
2-50 allows the governing body of the district to appoint a specified
2-51 number of members to the facility's medical peer review committee
2-52 or medical committee to evaluate medical and health care services
2-53 for which the district contracts with the facility to provide. The
2-54 governing body of a hospital district may receive a report from the
2-55 facility's medical per review committee or medical committee under
2-56 this section in a closed meeting. A report, information, or a
2-57 record that the district receives from the facility related to a
2-58 review action conducted under the terms of the contract is:
2-59 (1) confidential;
2-60 (2) not subject to disclosure under Chapter 552,
2-61 Government Code; and
2-62 (3) subject to the same confidentiality and disclosure
2-63 requirements to which a report, information, or record of a medical
2-64 peer review committee under Section 5.06(s), Medical Practice Act
2-65 (Article 4495b, Vernon's Texas Civil Statutes) is subject.
2-66 (d) If a hospital district and a health care facility
2-67 described by Subsection (b) do not agree on a contract provision
2-68 described by Subsection (c), the hospital district has, with
2-69 respect to a review action for the evaluation of medical and health
3-1 care services provided by the facility under a contract with the
3-2 district, a right to:
3-3 (1) initiate the review action;
3-4 (2) appoint from the medical staff of the facility a
3-5 number of members to the facility's medical peer review committee
3-6 or medical committee equal to the number of members appointed to
3-7 the committee by the facility to conduct the review action,
3-8 without regard to whether the district initiates the action; and
3-9 (3) receive records, information, or reports from the
3-10 medical peer review committee or medical committee related to the
3-11 review action.
3-12 (e) The governing body of a hospital district may receive a
3-13 report under Subsection (d)(3) in a closed meeting. A report,
3-14 information, or a record that the hospital district receives under
3-15 Subsection (d)(3) is:
3-16 (1) confidential;
3-17 (2) not subject to disclosure under Chapter 552,
3-18 Government Code; and
3-19 (3) subject to the same confidentiality and disclosure
3-20 requirements to which a report, information, or record of a medical
3-21 peer review committee under Section 5.06(s), Medical Practice Act
3-22 (Article 4495b, Vernon's Texas Civil Statutes) is subject.
3-23 SECTION 7. The importance of this legislation and the
3-24 crowded condition of the calendars in both houses create an
3-25 emergency and an imperative public necessity that the
3-26 constitutional rule requiring bills to be read on three several
3-27 days in each house be suspended, and this rule is hereby suspended,
3-28 and that this Act take effect and be in force from and after its
3-29 passage, and it is so enacted.
3-30 * * * * *