1-1 AN ACT
1-2 relating to cancer incidence reporting.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Section 82.002, Health and Safety Code, is
1-5 amended to read as follows:
1-6 Sec. 82.002. DEFINITIONS. In this chapter:
1-7 (1) "Cancer" includes:
1-8 (A) a large group of diseases characterized by
1-9 uncontrolled growth and spread of abnormal cells;
1-10 (B) any condition of tumors having the
1-11 properties of anaplasia, invasion, and metastasis;
1-12 (C) a cellular tumor the natural course of which
1-13 is fatal, including malignant and benign tumors of the central
1-14 nervous system; and
1-15 (D) malignant neoplasm, other than nonmelanoma
1-16 skin cancers such as basal and squamous cell carcinomas.
1-17 (2) ["Cancer treatment center" means a special health
1-18 facility devoted to the study, prevention, diagnosis, and
1-19 management of neoplastic and allied diseases.]
1-20 [(3)] "Clinical laboratory" means an accredited
1-21 facility in which:
1-22 (A) tests are performed identifying findings of
1-23 anatomical changes; and
1-24 (B) specimens are interpreted and pathological
1-25 diagnoses are made.
2-1 (3) [(4)] "Health care facility [Hospital]" means:
2-2 (A) a general or special hospital as defined by
2-3 [licensed under] Chapter 241 (Texas Hospital Licensing Law); [or]
2-4 (B) an ambulatory surgical center licensed under
2-5 Chapter 243;
2-6 (C) an institution licensed under Chapter 242;
2-7 or
2-8 (D) any other facility, including an outpatient
2-9 clinic, that provides diagnosis or treatment services to patients
2-10 with cancer.
2-11 (4) "Health care practitioner" means:
2-12 (A) a physician as defined by Section 151.002,
2-13 Occupations Code; or
2-14 (B) a person who practices dentistry as
2-15 described by Section 251.003, Occupations Code [The University of
2-16 Texas System Cancer Center].
2-17 [(5) "Precancerous disease" means abnormality of
2-18 development and organization of adult cells, which is a condition
2-19 of early cancer without the invasion of neighboring tissue.]
2-20 [(6) "Tumorous disease" means a new growth of tissue
2-21 in which the multiplication of cells is uncontrolled and
2-22 progressive, also called neoplasm. It is a swelling, enlargement,
2-23 or abnormal mass, either benign or malignant, that performs no
2-24 useful functions.]
2-25 SECTION 2. Section 82.003, Health and Safety Code, is
2-26 amended to read as follows:
3-1 Sec. 82.003. APPLICABILITY OF CHAPTER. This chapter applies
3-2 to records of cases of [precancerous and tumorous diseases
3-3 specified by the board and all cases of] cancer, diagnosed on or
3-4 after January 1, 1979, and to records of all ongoing cancer cases
3-5 [of those diseases] diagnosed before January 1, 1979.
3-6 SECTION 3. Section 82.005, Health and Safety Code, is
3-7 amended to read as follows:
3-8 Sec. 82.005. CONTENT OF REGISTRY. (a) The cancer registry
3-9 must be a central data bank of accurate, precise, and current
3-10 information that medical authorities agree serves as an invaluable
3-11 tool in the early recognition, prevention, cure, and control of
3-12 cancer [and specified precancerous and tumorous diseases].
3-13 (b) The cancer registry must include:
3-14 (1) a record of the cases of [precancerous and
3-15 tumorous diseases specified by the board and of] cancer that occur
3-16 in the state; and
3-17 (2) information concerning cancer [those] cases as the
3-18 board considers necessary and appropriate for the recognition,
3-19 prevention, cure, or control of cancer [those diseases].
3-20 SECTION 4. Section 82.006, Health and Safety Code, is
3-21 amended to read as follows:
3-22 Sec. 82.006. BOARD POWERS. To implement this chapter, the
3-23 board may:
3-24 (1) adopt rules that the board considers necessary;
3-25 (2) execute contracts that the board considers
3-26 necessary;
4-1 (3) receive the data from medical records of cases of
4-2 cancer [or precancerous or tumorous disease] that are in the
4-3 custody or under the control of clinical laboratories, health care
4-4 facilities [hospitals], and health care practitioners [cancer
4-5 treatment centers] to record and analyze the data directly related
4-6 to those diseases;
4-7 (4) compile and publish statistical and other studies
4-8 derived from the patient data obtained under this chapter to
4-9 provide, in an accessible form, information that is useful to
4-10 physicians, other medical personnel, and the general public;
4-11 (5) comply with requirements as necessary to obtain
4-12 federal funds in the maximum amounts and most advantageous
4-13 proportions possible;
4-14 (6) receive and use gifts made for the purpose of this
4-15 chapter; and
4-16 (7) limit cancer reporting activities under this
4-17 chapter to specified geographic areas of the state to ensure
4-18 optimal use of funds available for obtaining the data.
4-19 SECTION 5. Section 82.008, Health and Safety Code, is
4-20 amended by amending Subsections (a), (b), (d), and (e) and adding
4-21 Subsections (f), (g), and (h) to read as follows:
4-22 (a) To ensure an accurate and continuing source of data
4-23 concerning [precancerous and tumorous diseases specified by the
4-24 board and concerning] cancer, each health care facility [hospital],
4-25 clinical laboratory, and health care practitioner [cancer treatment
4-26 center] shall furnish to the board or its representative, on
5-1 request, data the board considers necessary and appropriate that is
5-2 derived from each medical record pertaining to [of] a case of
5-3 cancer [one of those diseases] that is in the custody or under the
5-4 control of the health care facility, clinical [hospital,]
5-5 laboratory, or health care practitioner. The department may not
5-6 request data that is more than three years old unless the
5-7 department is investigating a possible cancer cluster [treatment
5-8 center].
5-9 (b) A health care facility [hospital], clinical laboratory,
5-10 or health care practitioner [cancer treatment center] shall furnish
5-11 the data requested under Subsection (a) in a reasonable format
5-12 prescribed by the department and within six months of the patient's
5-13 admission, diagnosis, or treatment for cancer unless a different
5-14 period is prescribed by the United States Department of Health and
5-15 Human Services.
5-16 (d) The department may access medical records that would
5-17 identify cases of cancer, establish characteristics or treatment of
5-18 cancer, or determine the medical status of any identified patient
5-19 from the following sources:
5-20 (1) a health care facility or clinical laboratory
5-21 providing screening, diagnostic, or therapeutic services to a
5-22 patient with respect to cancer; or
5-23 (2) a health care practitioner diagnosing or providing
5-24 treatment to a patient with cancer, except as described by
5-25 Subsection (g) [board by rule may determine a reasonable amount for
5-26 compensation to the hospital, clinical laboratory, or cancer
6-1 treatment center for the cost of collecting or furnishing the data
6-2 and shall pay that amount, within the limits of funds appropriated
6-3 expressly for that purpose].
6-4 (e) The board shall adopt procedures that ensure adequate
6-5 notice is given to the health care facility, clinical laboratory,
6-6 or health care practitioner before the department accesses data
6-7 under Subsection (d).
6-8 (f) A health care facility, clinical laboratory, or health
6-9 care practitioner that knowingly or in bad faith fails to furnish
6-10 data as required by this chapter shall reimburse the department or
6-11 its authorized representative for the costs of accessing and
6-12 reporting the data. The costs reimbursed under this subsection
6-13 must be reasonable, based on the actual costs incurred by the
6-14 department or by its authorized representative in the collection of
6-15 data under Subsection (d), and may include salary and travel
6-16 expenses. The department may assess a late fee on an account that
6-17 is 60 days or more overdue. The late fee may not exceed one and
6-18 one-half percent of the total amount due on the late account for
6-19 each month or portion of a month the account is not paid in full.
6-20 A health care facility, clinical laboratory, or health care
6-21 practitioner may request that the department conduct a hearing to
6-22 determine whether reimbursement to the department under this
6-23 subsection is appropriate.
6-24 (g) The department may not require a health care
6-25 practitioner to furnish data or provide access to records if:
6-26 (1) the data or records pertain to cases reported by a
7-1 health care facility providing screening, diagnostic, or
7-2 therapeutic services to cancer patients that involve patients
7-3 referred directly to or previously admitted to the facility; and
7-4 (2) the facility reported the same data the
7-5 practitioner would be required to report.
7-6 (h) The data required to be furnished under this section may
7-7 [also] be shared with [furnished only to:]
7-8 [(1)] cancer registries of health care facilities
7-9 subject to the confidentiality provisions in Section 82.009
7-10 [hospitals; and]
7-11 [(2) cancer registries of cancer treatment centers].
7-12 SECTION 6. Section 82.009, Health and Safety Code, is
7-13 amended to read as follows:
7-14 Sec. 82.009. CONFIDENTIALITY. (a) Reports, records, and
7-15 information [Data] obtained under this chapter are confidential and
7-16 are not subject to disclosure under Chapter 552, Government Code,
7-17 are not subject to subpoena, and may not otherwise be released or
7-18 made public except as provided by this section or Section
7-19 82.008(h). The reports, records, and information obtained under
7-20 this chapter are [directly from the medical records of a patient
7-21 is] for the confidential use of the department and the persons or
7-22 public or private entities that the department [board] determines
7-23 are necessary to carry out the intent of this chapter. [The data
7-24 is privileged and may not be divulged or made public in a manner
7-25 that discloses the identity of an individual whose medical records
7-26 have been used for obtaining data under this chapter.]
8-1 (b) Medical or epidemiological information may be released:
8-2 (1) for statistical purposes in a manner that prevents
8-3 identification of individuals, health care facilities, clinical
8-4 laboratories, or health care practitioners;
8-5 (2) with the consent of each person identified in the
8-6 information; or
8-7 (3) to promote cancer research, including release of
8-8 information to other cancer registries and appropriate state and
8-9 federal agencies, under rules adopted by the board to ensure
8-10 confidentiality as required by state and federal laws.
8-11 [Information that may identify an individual whose medical records
8-12 have been used for obtaining data under this chapter is not
8-13 available for public inspection under Chapter 552, Government
8-14 Code.]
8-15 (c) A state employee may not testify in a civil, criminal,
8-16 special, or other proceeding as to the existence or contents of
8-17 records, reports, or information concerning an individual whose
8-18 medical records have been used in submitting data required under
8-19 this chapter unless the individual consents in advance.
8-20 [Statistical information collected under this chapter is public
8-21 information.]
8-22 (d) Data furnished to a [hospital] cancer registry or a
8-23 cancer researcher [treatment center cancer registry] under
8-24 Subsection (b) or Section 82.008(h) [Section 82.008(e)] is for the
8-25 confidential use of the [hospital] cancer registry or the cancer
8-26 researcher [treatment center cancer registry], as applicable, and
9-1 is subject to Subsection (a).
9-2 SECTION 7. Section 82.010, Health and Safety Code, is
9-3 amended to read as follows:
9-4 Sec. 82.010. IMMUNITY FROM LIABILITY. The following persons
9-5 subject to this chapter that act in compliance with this chapter
9-6 are not civilly or criminally liable for furnishing the information
9-7 required under this chapter:
9-8 (1) a health care facility or [hospital,] clinical
9-9 laboratory[, or cancer treatment center];
9-10 (2) an administrator, officer, or employee of a health
9-11 care facility or [hospital,] clinical laboratory[, or cancer
9-12 treatment center]; [and]
9-13 (3) a health care practitioner or employee of a health
9-14 care practitioner; and
9-15 (4) an employee of the department [physician].
9-16 SECTION 8. This Act takes effect September 1, 2001.
_______________________________ _______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 285 passed the Senate on
March 22, 2001, by the following vote: Yeas 30, Nays 0, one
present, not voting; and that the Senate concurred in House
amendment on May 17, 2001, by a viva-voce vote.
_______________________________
Secretary of the Senate
I hereby certify that S.B. No. 285 passed the House, with
amendment, on May 11, 2001, by a non-record vote.
_______________________________
Chief Clerk of the House
Approved:
_______________________________
Date
_______________________________
Governor