1-1 AN ACT
1-2 relating to disclosure of medical billing records regarding a
1-3 patient.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Section 159.001, Occupations Code, is amended to
1-6 read as follows:
1-7 Sec. 159.001. DEFINITIONS [DEFINITION]. In this chapter:
1-8 (1) "Billing record" means a record that describes
1-9 charges for services provided to a patient by a physician.
1-10 (2) "Medical record" does not include a billing
1-11 record.
1-12 (3) "Patient" [, "patient"] means a person who, to
1-13 receive medical care, consults with or is seen by a physician.
1-14 SECTION 2. Section 159.003(a), Occupations Code, is amended
1-15 to read as follows:
1-16 (a) An exception to the privilege of confidentiality in a
1-17 court or administrative proceeding exists:
1-18 (1) in a proceeding brought by a patient against a
1-19 physician, including:
1-20 (A) a malpractice proceeding; or
1-21 (B) a criminal proceeding or license revocation
1-22 proceeding in which the patient is a complaining witness and
1-23 disclosure is relevant to a claim or defense of the physician;
1-24 (2) if the patient or a person authorized to act on
2-1 the patient's behalf submits a written consent to the release of
2-2 confidential information as provided by Section 159.005;
2-3 (3) in a proceeding to substantiate and collect on a
2-4 claim for medical services provided to the patient;
2-5 (4) in a civil action or administrative proceeding, if
2-6 relevant, brought by the patient or a person on the patient's
2-7 behalf, if the patient or person is attempting to recover monetary
2-8 damages for a physical or mental condition including the patient's
2-9 death;
2-10 (5) in a disciplinary investigation or proceeding
2-11 conducted under this subtitle, if the board protects the identity
2-12 of any patient whose billing or medical records are examined other
2-13 than a patient:
2-14 (A) for whom an exception exists under
2-15 Subdivision (1); or
2-16 (B) who has submitted written consent to the
2-17 release of the billing or medical records as provided by Section
2-18 159.005;
2-19 (6) in a criminal investigation of a physician in
2-20 which the board is participating, or assisting in the investigation
2-21 or proceeding by providing certain billing or medical records
2-22 obtained from the physician, if the board protects the identity of
2-23 a patient whose billing or medical records are provided in the
2-24 investigation or proceeding other than a patient:
2-25 (A) for whom an exception exists under
2-26 Subdivision (1); or
2-27 (B) who has submitted written consent to the
3-1 release of the billing or medical records as provided by Section
3-2 159.005;
3-3 (7) in an involuntary civil commitment proceeding,
3-4 proceeding for court-ordered treatment, or probable cause hearing
3-5 under Chapter 462, 574, or 593, Health and Safety Code;
3-6 (8) if the patient's physical or mental condition is
3-7 relevant to the execution of a will;
3-8 (9) if the information is relevant to a proceeding
3-9 brought under Section 159.009;
3-10 (10) in a criminal prosecution in which the patient is
3-11 a victim, witness, or defendant;
3-12 (11) to satisfy a request for billing or medical
3-13 records of a deceased or incompetent person under Section 4.01(e),
3-14 Medical Liability and Insurance Improvement Act of Texas (Article
3-15 4590i, Vernon's Texas Civil Statutes); or
3-16 (12) to a court or a party to an action under a court
3-17 order or court subpoena.
3-18 SECTION 3. Section 159.004, Occupations Code, is amended to
3-19 read as follows:
3-20 Sec. 159.004. EXCEPTIONS TO CONFIDENTIALITY IN OTHER
3-21 SITUATIONS. An exception to the privilege of confidentiality in a
3-22 situation other than a court or administrative proceeding, allowing
3-23 disclosure of confidential information by a physician, exists only
3-24 with respect to the following:
3-25 (1) a governmental agency, if the disclosure is
3-26 required or authorized by law;
3-27 (2) medical or law enforcement personnel, if the
4-1 physician determines that there is a probability of:
4-2 (A) imminent physical injury to the patient, the
4-3 physician, or another person; or
4-4 (B) immediate mental or emotional injury to the
4-5 patient;
4-6 (3) qualified personnel for research or for a
4-7 management audit, financial audit, or program evaluation, but the
4-8 personnel may not directly or indirectly identify a patient in any
4-9 report of the research, audit, or evaluation or otherwise disclose
4-10 identity in any manner;
4-11 (4) those parts of the medical records reflecting
4-12 [charges and] specific services provided if necessary in the
4-13 collection of fees for medical services provided by a physician,
4-14 professional association, or other entity qualified to provide or
4-15 arrange for medical services;
4-16 (5) a person who has [the written] consent [of the
4-17 patient or other person authorized to act on the patient's behalf
4-18 for the release of confidential information], as provided by
4-19 Section 159.005;
4-20 (6) a person, corporation, or governmental agency
4-21 involved in the payment or collection of fees for medical services
4-22 provided by a physician;
4-23 (7) another physician or other personnel acting under
4-24 the direction of the physician who participate in the diagnosis,
4-25 evaluation, or treatment of the patient;
4-26 (8) an official legislative inquiry regarding state
4-27 hospitals or state schools, if:
5-1 (A) information or a record that identifies a
5-2 patient or client is not released for any purpose unless proper
5-3 consent to the release is given by the patient; and
5-4 (B) only records created by the state hospital
5-5 or school or its employees are included; or
5-6 (9) health care personnel of a penal or other
5-7 custodial institution in which the patient is detained if the
5-8 disclosure is for the sole purpose of providing health care to the
5-9 patient.
5-10 SECTION 4. Section 159.005(b), Occupations Code, is amended
5-11 to read as follows:
5-12 (b) The written consent must specify:
5-13 (1) the billing records, [information or] medical
5-14 records, or other information to be covered by the release;
5-15 (2) the reasons or purposes for the release; and
5-16 (3) the person to whom the information is to be
5-17 released.
5-18 SECTION 5. Section 159.006, Occupations Code, is amended to
5-19 read as follows:
5-20 Sec. 159.006. INFORMATION FURNISHED BY PHYSICIAN. (a)
5-21 Unless the physician determines that access to the information
5-22 would be harmful to the physical, mental, or emotional health of
5-23 the patient, a physician who receives a written consent for release
5-24 of information as provided by Section 159.005 shall furnish copies
5-25 of the requested billing or medical records, or a summary or
5-26 narrative of the records, including records received from a
5-27 physician or other health care provider involved in the care or
6-1 treatment of the patient.
6-2 (b) The physician may delete confidential information about
6-3 another patient or a family member of the patient who has not
6-4 consented to the release.
6-5 (c) In accordance with Section 159.005, on receipt of a
6-6 written request by a subsequent or consulting physician of a
6-7 patient of the requested physician, the requested physician shall
6-8 furnish a copy of the complete billing or medical records of the
6-9 patient to the subsequent or consulting physician. The duty to
6-10 provide billing or medical records to a subsequent or consulting
6-11 physician may not be nullified by contract.
6-12 (d) A physician shall provide the information requested
6-13 under this section not later than the 15th business day after the
6-14 date of receipt of the written consent for release under Subsection
6-15 (a) or the written request under Subsection (c).
6-16 (e) If the physician denies the request, in whole or in
6-17 part, the physician shall:
6-18 (1) furnish the patient with a written statement,
6-19 signed and dated, providing the reason for the denial; and
6-20 (2) place a copy of the statement denying the request
6-21 in the patient's:
6-22 (A) billing records, if the request was for
6-23 billing records; or
6-24 (B) medical records, if the request was for
6-25 medical records.
6-26 SECTION 6. Chapter 159, Occupations Code, is amended by
6-27 adding Section 159.0061 to conform to Section 1, Chapter 636, Acts
7-1 of the 76th Legislature, Regular Session, 1999, and by amending
7-2 that section to read as follows:
7-3 Sec. 159.0061. APPOINTMENT OF CUSTODIAN OF PHYSICIAN'S
7-4 RECORDS. (a) The board by rule shall establish conditions under
7-5 which the board may temporarily or permanently appoint a person as
7-6 a custodian of a physician's billing or medical records. In
7-7 adopting rules under this section, the board shall consider the
7-8 death of a physician, the mental or physical incapacitation of a
7-9 physician, and the abandonment of billing or medical records by a
7-10 physician.
7-11 (b) The rules adopted under this section must provide for:
7-12 (1) the release of the billing or medical records by
7-13 an appointed custodian in compliance with this chapter; and
7-14 (2) a fee charged by the appointed custodian that is
7-15 in addition to the copying fee governed by Section 159.008.
7-16 SECTION 7. Section 159.008, Occupations Code, is amended to
7-17 read as follows:
7-18 Sec. 159.008. PHYSICIAN FEES FOR INFORMATION. (a) Except
7-19 as provided by Subsection (b), a physician:
7-20 (1) may charge a reasonable fee, as prescribed by
7-21 board rule, for copying billing or medical records; and
7-22 (2) is not required to permit examination or copying
7-23 of the records until the fee is paid unless there is a medical
7-24 emergency.
7-25 (b) A physician may not charge a fee for copying billing or
7-26 medical records under Subsection (a) to the extent the fee is
7-27 prohibited under Subchapter M, Chapter 161, Health and Safety Code.
8-1 SECTION 8. (a) In accordance with Section 311.031(c),
8-2 Government Code, which gives effect to a substantive amendment
8-3 enacted by the same legislature that codifies the amended statute,
8-4 the text of Section 159.006, Occupations Code, as set out in
8-5 Section 5 of this Act, gives effect to changes made by Chapter 636,
8-6 Acts of the 76th Legislature, Regular Session, 1999.
8-7 (b) To the extent of any conflict, this Act prevails over
8-8 another Act of the 77th Legislature, Regular Session, 2001,
8-9 relating to nonsubstantive additions and corrections in enacted
8-10 codes.
8-11 SECTION 9. This Act takes effect immediately if it receives
8-12 a vote of two-thirds of all the members elected to each house, as
8-13 provided by Section 39, Article III, Texas Constitution. If this
8-14 Act does not receive the vote necessary for immediate effect, this
8-15 Act takes effect September 1, 2001.
_______________________________ _______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 398 was passed by the House on May 5,
2001, by the following vote: Yeas 140, Nays 0, 2 present, not
voting.
_______________________________
Chief Clerk of the House
I certify that H.B. No. 398 was passed by the Senate on May
23, 2001, by the following vote: Yeas 30, Nays 0, 1 present, not
voting.
_______________________________
Secretary of the Senate
APPROVED: __________________________
Date
__________________________
Governor