HBA-MSH, CBW C.S.S.B. 285 77(R)BILL ANALYSIS Office of House Bill AnalysisC.S.S.B. 285 By: Nelson Public Health 5/4/2001 Committee Report (Substituted) BACKGROUND AND PURPOSE Cancer is the second leading cause of death among Americans. For the year 2001, the American Cancer Society (ACS) estimates that 1,268,000 new cancer cases will be diagnosed in the United States, including 78,900 in Texas. ACS also estimates that 553,400 cancer deaths will occur in the United States, including 34,400 in Texas. Increased funding and a better reporting system could help prevent and control cancer. Texas could be eligible to receive federal funding from the Centers for Disease Control and Prevention under the National Program of Cancer Registries if the state had a systematic method of reporting cancer cases. C.S.S.B. 285 sets forth provisions regarding access by authorizes the Texas Department of Health to certain medical records from a health care facility, clinical laboratory, or health care practitioner. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the Texas Board of Health in SECTION 6 (Section 82.009, Health and Safety Code) of this bill. ANALYSIS C.S.S.B. 285 amends the Health and Safety Code to include health care practitioners in the reporting requirements of the Texas Cancer Incidence Reporting Act (TCIRA). The bill removes precancerous and tumorous disease specified by the Texas Board of Health (board) from the reporting requirements. The bill authorizes the Texas Department of Health (TDH) to access the medical records of a health care facility, clinical laboratory, or health care practitioner (health entity) that would identify cases of cancer, establish characteristics of treatment of cancer, or determine the medical status of any identified patient. The bill prohibits TDH from requesting data that is more than three years old unless TDH is investigating a possible cancer cluster. The bill requires health entities to furnish requested data in a reasonable format and within six months of the patient's admission, diagnosis, or treatment for cancer unless a different period is prescribed by the United States Department of Health and Human Services. The bill deletes the requirement for the board to pay a reasonable compensation amount to a health entity for the cost of collecting or furnishing cancer data. The bill requires the board to adopt procedures that ensure adequate notice is given to the health entity before TDH accesses data. The bill requires a health entity that knowingly or in bad faith fails to furnish required data to reimburse TDH for the reasonable costs of accessing and reporting the data. The bill authorizes TDH to assess a late fee on an account that is 60 days or more overdue and prohibits the late fee from exceeding one and one-half percent of the total amount due on the late account for each month or portion of a month the account is not paid in full. The bill authorizes a health entity to request that TDH conduct a hearing to determine whether reimbursement is appropriate. The bill prohibits TDH from requiring a health care practitioner to provide data already provided by a health care facility (Sec. 82.008). The bill establishes the confidentiality of the reports, records, and information obtained under TCIRA. The bill authorizes medical or epidemiological information to be released under certain conditions. The bill prohibits a state employee from testifying in a proceeding regarding the existence or contents of records, reports, or information concerning an individual without prior consent of the individual (Sec. 82.009). The bill exempts a health care practitioner or employee of a health care practitioner and an employee of TDH from liability for furnishing required information (Sec. 82.010). EFFECTIVE DATE September 1, 2001. COMPARISON OF ORIGINAL TO SUBSTITUTE C.S.S.B. 285 differs from the original by deleting precancerous and tumorous diseases specified by the Texas Board of Health (board) from the reporting requirements. The substitute specifies that medical records TDH is authorized to access are those that would identify cases of cancer, establish characteristics or treatment of cancer, or determine the medical status of any identified patient in order to be accessed. The substitute prohibits the Texas Department of Health (TDH) from requesting data that is more than three years old. The substitute requires a health care facility, clinical laboratory, or health care practitioner (health entity) to furnish requested data in a reasonable format and within a specified time. The substitute requires only a health entity that knowingly and in bad faith failed to furnish, rather than simply failed to furnish, required data to reimburse TDH. The substitute authorizes a health entity to request that TDH conduct a hearing regarding the appropriateness of a reimbursement. The substitute prohibits TDH from requiring a health care practitioner to provide data already provided by a health care facility (Sec. 82.008). The substitute adds an employee of TDH to the list of those who are exempt from liability for furnishing reporting data (Sec. 82.010). The substitute modifies the conditions under which medical or epidemiological information may be released (Sec. 82.009). The substitute modifies the definition of cancer (Sec. 82.002).