By Gray H.B. No. 2633
Line and page numbers may not match official copy.
Bill not drafted by TLC or Senate E&E.
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the confidentiality of dental patient records.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. The Dental Practice Act (Chapter 9, Title 71,
1-5 Civil Statutes) is amended by adding Article 4549-3 to read as
1-6 follows:
1-7 Article 4549-3. CONFIDENTIALITY OF DENTAL PATIENT RECORDS
1-8 Sec. 1. DEFINITION. In this article, "dental record" means
1-9 any record relating to the history, diagnosis, treatment, or
1-10 prognosis of a dental patient.
1-11 Sec. 2. SCOPE OF PRIVILEGE. (a) A communication that
1-12 relates to or is in connection with professional services rendered
1-13 as a dentist, between a dentist and a patient, is confidential and
1-14 privileged and may not be disclosed except as provided by this
1-15 article.
1-16 (b) Records of the identity, diagnosis, evaluation, or
1-17 treatment of a patient by a dentist that are created or maintained
1-18 by a dentist are confidential and privileged and may not be
1-19 disclosed except as provided by this article.
1-20 (c) A person who receives information from confidential
1-21 communications or dental records, other than a person listed under
2-1 Section 5 or 6 of this article who is acting on a patient's behalf,
2-2 may not disclose the information except to the extent that
2-3 disclosure is consistent with the authorized purposes for which the
2-4 information was first obtained.
2-5 (d) The prohibitions of this section continue to apply to
2-6 confidential communications or records concerning a patient
2-7 irrespective of when the patient received the services of a
2-8 dentist.
2-9 Sec. 3. CLAIM OF PRIVILEGE. (a) The privilege of
2-10 confidentiality under this article may be claimed by the patient or
2-11 by a dentist acting on the patient's behalf.
2-12 (b) The dentist may claim the privilege of confidentiality
2-13 only on behalf of the patient. The authority to claim the privilege
2-14 is presumed in the absence of evidence to the contrary.
2-15 Sec. 4. EXCEPTIONS. (a) An exception to the
2-16 confidentiality and privilege requirements under this article
2-17 exists in a court or administrative proceeding if:
2-18 (1) the proceeding is brought by the patient against a
2-19 dentist, including a malpractice proceeding or any criminal or
2-20 license revocation proceeding in which the patient is a complaining
2-21 witness and in which disclosure is relevant to the claims or
2-22 defense of a dentist.
2-23 (2) the patient or a person authorized to act on the
2-24 patient's behalf submits written consent to the release of any
2-25 confidential information, as provided by Section 6 of this article;
3-1 or
3-2 (3) the purpose of the proceeding is to substantiate
3-3 and collect on a claim for dental services rendered to the patient.
3-4 (b) An exception to the confidentiality and privilege
3-5 requirements under this article exists in a civil litigation or
3-6 administrative proceeding that is brought by the patient or another
3-7 person on the patient's behalf if the plaintiff is attempting to
3-8 recover monetary damages for any physical or mental condition,
3-9 including the death of a patient. Information is discoverable in a
3-10 court or administrative proceeding in this state if the information
3-11 is relevant to the proceeding and the court or administrative body
3-12 had jurisdiction over the subject matter under the applicable rules
3-13 of procedure specified for that matter.
3-14 (c) An exception to the confidentiality and privilege
3-15 requirements under this article exists in a disciplinary
3-16 investigation or proceeding against a dentist conducted under the
3-17 Dental Practice Act. The board shall protect the identity of any
3-18 patient whose dental records are examined under this subsection,
3-19 other than those patients:
3-20 (1) covered under subsection (a)(1) of this section;
3-21 or
3-22 (2) who have submitted written consent to the release
3-23 of their dental records as provided by Section 6 of this article.
3-24 (d) An exception to the confidentiality and privilege
3-25 requirements under this article exists in a criminal investigation
4-1 of or criminal proceeding against a dentist in which the board is
4-2 participating or assisting by providing certain records obtained
4-3 from the dentist. The board shall protect the identity of any
4-4 patient whose records are provided in the investigation or
4-5 proceeding, other than patients covered under subsection (a)(1) of
4-6 this section or who have submitted written consent to the release
4-7 of their dental records as provided by Section 6 of this article.
4-8 This subsection does not authorize the release of any confidential
4-9 information for the purpose of instigating or substantiating
4-10 criminal charges against a patient.
4-11 (e) An exception to the confidentiality or privilege
4-12 requirements under this article exists in a criminal prosecution in
4-13 which the patient is a victim, witness, or defendant. Records or
4-14 communications are not discoverable under this subsection until the
4-15 court in which the prosecution is pending makes an in camera
4-16 determination as to the relevancy of the records or communications
4-17 or any portion of the records or communications. That
4-18 determination does not constitute a determination as to the
4-19 admissibility of the records or communications or any portion of
4-20 the records or communications.
4-21 Sec. 5. DISCLOSURE OF OTHERWISE CONFIDENTIAL INFORMATION.
4-22 (a) In circumstances other than those described by Section 4, an
4-23 exception to the confidentiality or privilege requirements of this
4-24 article exists only for, and a dentist may disclose confidential
4-25 information only to:
5-1 (1) a governmental agency, if:
5-2 (A) the disclosure is required or permitted by
5-3 law; and
5-4 (B) the agency protects the identity of any
5-5 patient whose dental records are examined;
5-6 (2) medical or law enforcement personnel, if the
5-7 dentist determines that there is a possibility of:
5-8 (A) imminent physical injury to a patient, the
5-9 dentist or others; or
5-10 (B) immediate mental or emotional injury to the
5-11 patient;
5-12 (3) qualified personnel for the purpose of management
5-13 audits, financial audits, program evaluations, or research;
5-14 (4) a person who presents the written consent of the
5-15 patient or another person authorized to act on the patient's behalf
5-16 for the release of confidential information, as provided by Section
5-17 6 of this article;
5-18 (5) an individual, corporation, or governmental entity
5-19 involved in the payment or collection of fees for services rendered
5-20 by a dentist; or
5-21 (6) another dentist and persons under the direction of
5-22 the dentist who are participating in the diagnosis, evaluation, or
5-23 treatment of the patient.
5-24 (b) A person who receives information under subsection
5-25 (a)(3) of this section may not identify a patient, directly or
6-1 indirectly, in any report of the research, audit, or evaluation or
6-2 otherwise disclose a patient's identity.
6-3 (c) Records reflecting charges and specific services
6-4 rendered may be disclosed only when necessary in the collection of
6-5 fees for services provided by a dentist, professional association,
6-6 or other entity qualified to render or arrange for services.
6-7 (d) Information otherwise confidential under this article
6-8 may be disclosed in an official legislative inquiry regarding a
6-9 state hospital or state school. However, information or records
6-10 that identify a patient or client may not be released for any
6-11 purposes unless the patient gives proper consent to the release.
6-12 This subsection applies only to records created by the state
6-13 hospital, state school, or an employee of the state hospital or
6-14 state school.
6-15 Sec. 6. CONSENT. (a) Consent for the release of
6-16 confidential information must be made in writing and signed by:
6-17 (1) the patient;
6-18 (2) a parent or legal guardian if the patient is a
6-19 minor;
6-20 (3) a legal guardian if the patient has been
6-21 adjudicated incompetent to manage the patient's personal affairs;
6-22 (4) an attorney ad litem appointed for the patient, as
6-23 authorized by:
6-24 (A) the Texas Mental Health Code (Subtitle C,
6-25 Title 7, Health and Safety Code);
7-1 (B) the Persons with Mental Retardation Act
7-2 (Subtitle D, Title 7, Health and Safety Code);
7-3 (C) Subtitle B, Title 6, Health and Safety Code;
7-4 (D) Subtitle E, Title 7, Health and Safety Code;
7-5 (E) Chapter 5, Texas Probate Code;
7-6 (F) Chapter 11, Family Code; or
7-7 (G) another applicable law; or
7-8 (5) a personal representative if the patient is
7-9 deceased.
7-10 (b) The written consent required under this section must
7-11 specify:
7-12 (1) the information and records to be covered by the
7-13 release;
7-14 (2) the reasons or purposes for the release; and
7-15 (3) the person to whom the information is to be
7-16 released.
7-17 (c) The patient or other person authorized to consent has
7-18 the right to withdraw the consent to the release of any
7-19 information. Withdrawal of consent does not affect information
7-20 disclosed before the written notice of the withdrawal.
7-21 Sec. 7. FURNISHING INFORMATION. A person who receives
7-22 information made confidential by this article may disclose the
7-23 information to others only to the extent consistent with the
7-24 authorized purposes for which consent to release the information
7-25 was obtained.
8-1 Sec. 8. SUBSEQUENT DISCLOSURE. (a) A dentist shall furnish
8-2 copies of dental records requested or a summary or narrative of the
8-3 records under a written consent for release of the information as
8-4 provided by Section 6 of this article unless the dentist determines
8-5 that access to the information would be harmful to the physical,
8-6 mental or emotional health of the patient. The dentist may delete
8-7 confidential information about another person who has not consented
8-8 to the release.
8-9 (b) The information shall be furnished by the dentist within
8-10 a reasonable period of time, and reasonable fees for furnishing the
8-11 information shall be paid by the patient or another person acting
8-12 on the patient's behalf.
8-13 Sec. 9. The importance of this legislation and the crowded
8-14 condition of the calendars in both houses create an emergency and
8-15 an imperative public necessity that the constitutional rule
8-16 requiring bills to be read on three several days in each house be
8-17 suspended, and this rule is hereby suspended, and that this Act
8-18 take effect and be in force from and after its passage, and it is
8-19 so enacted.