77R14497 YDB-D
By Nelson S.B. No. 285
Substitute the following for S.B. No. 285:
By Delisi C.S.S.B. No. 285
A BILL TO BE ENTITLED
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 amended
1-5 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
2-1 diagnoses are made.
2-2 (3) [(4)] "Health care facility [Hospital]" means:
2-3 (A) a general or special hospital as defined by
2-4 [licensed under] Chapter 241 (Texas Hospital Licensing Law); [or]
2-5 (B) an ambulatory surgical center licensed under
2-6 Chapter 243;
2-7 (C) an institution licensed under Chapter 242;
2-8 or
2-9 (D) any other facility, including an outpatient
2-10 clinic, that provides diagnosis or treatment services to patients
2-11 with cancer.
2-12 (4) "Health care practitioner" means:
2-13 (A) a physician as defined by Section 151.002,
2-14 Occupations Code; or
2-15 (B) a person who practices dentistry as
2-16 described by Section 251.003, Occupations Code [The University of
2-17 Texas System Cancer Center].
2-18 [(5) "Precancerous disease" means abnormality of
2-19 development and organization of adult cells, which is a condition
2-20 of early cancer without the invasion of neighboring tissue.]
2-21 [(6) "Tumorous disease" means a new growth of tissue
2-22 in which the multiplication of cells is uncontrolled and
2-23 progressive, also called neoplasm. It is a swelling, enlargement,
2-24 or abnormal mass, either benign or malignant, that performs no
2-25 useful functions.]
2-26 SECTION 2. Section 82.003, Health and Safety Code, is amended
2-27 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 amended
3-7 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 amended
3-21 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;
3-27 (3) receive the data from medical records of cases of
4-1 cancer [or precancerous or tumorous disease] that are in the
4-2 custody or under the control of clinical laboratories, health care
4-3 facilities [hospitals], and health care practitioners [cancer
4-4 treatment centers] to record and analyze the data directly related
4-5 to those diseases;
4-6 (4) compile and publish statistical and other studies
4-7 derived from the patient data obtained under this chapter to
4-8 provide, in an accessible form, information that is useful to
4-9 physicians, other medical personnel, and the general public;
4-10 (5) comply with requirements as necessary to obtain
4-11 federal funds in the maximum amounts and most advantageous
4-12 proportions possible;
4-13 (6) receive and use gifts made for the purpose of this
4-14 chapter; and
4-15 (7) limit cancer reporting activities under this
4-16 chapter to specified geographic areas of the state to ensure
4-17 optimal use of funds available for obtaining the data.
4-18 SECTION 5. Section 82.008, Health and Safety Code, is amended
4-19 by amending Subsections (a), (b), (d), and (e) and adding
4-20 Subsections (f), (g), and (h) to read as follows:
4-21 (a) To ensure an accurate and continuing source of data
4-22 concerning [precancerous and tumorous diseases specified by the
4-23 board and concerning] cancer, each health care facility [hospital],
4-24 clinical laboratory, and health care practitioner [cancer treatment
4-25 center] shall furnish to the board or its representative, on
4-26 request, data the board considers necessary and appropriate that is
4-27 derived from each medical record pertaining to [of] a case of
5-1 cancer [one of those diseases] that is in the custody or under the
5-2 control of the health care facility, clinical [hospital,]
5-3 laboratory, or health care practitioner. The department may not
5-4 request data that is more than three years old unless the
5-5 department is investigating a possible cancer cluster [treatment
5-6 center].
5-7 (b) A health care facility [hospital], clinical laboratory,
5-8 or health care practitioner [cancer treatment center] shall furnish
5-9 the data requested under Subsection (a) in a reasonable format
5-10 prescribed by the department and within six months of the patient's
5-11 admission, diagnosis, or treatment for cancer unless a different
5-12 period is prescribed by the United States Department of Health and
5-13 Human Services.
5-14 (d) The department may access medical records that would
5-15 identify cases of cancer, establish characteristics or treatment of
5-16 cancer, or determine the medical status of any identified patient
5-17 from the following sources:
5-18 (1) a health care facility or clinical laboratory
5-19 providing screening, diagnostic, or therapeutic services to a
5-20 patient with respect to cancer; or
5-21 (2) a health care practitioner diagnosing or providing
5-22 treatment to a patient with cancer, except as described by
5-23 Subsection (g) [board by rule may determine a reasonable amount for
5-24 compensation to the hospital, clinical laboratory, or cancer
5-25 treatment center for the cost of collecting or furnishing the data
5-26 and shall pay that amount, within the limits of funds appropriated
5-27 expressly for that purpose].
6-1 (e) The board shall adopt procedures that ensure adequate
6-2 notice is given to the health care facility, clinical laboratory,
6-3 or health care practitioner before the department accesses data
6-4 under Subsection (d).
6-5 (f) A health care facility, clinical laboratory, or health
6-6 care practitioner that knowingly or in bad faith fails to furnish
6-7 data as required by this chapter shall reimburse the department or
6-8 its authorized representative for the costs of accessing and
6-9 reporting the data. The costs reimbursed under this subsection
6-10 must be reasonable, based on the actual costs incurred by the
6-11 department or by its authorized representative in the collection of
6-12 data under Subsection (d), and may include salary and travel
6-13 expenses. The department may assess a late fee on an account that
6-14 is 60 days or more overdue. The late fee may not exceed one and
6-15 one-half percent of the total amount due on the late account for
6-16 each month or portion of a month the account is not paid in full. A
6-17 health care facility, clinical laboratory, or health care
6-18 practitioner may request that the department conduct a hearing to
6-19 determine whether reimbursement to the department under this
6-20 subsection is appropriate.
6-21 (g) The department may not require a health care
6-22 practitioner to furnish data or provide access to records if:
6-23 (1) the data or records pertain to cases reported by a
6-24 health care facility providing screening, diagnostic, or
6-25 therapeutic services to cancer patients that involve patients
6-26 referred directly to or previously admitted to the facility; and
6-27 (2) the facility reported the same data the
7-1 practitioner would be required to report.
7-2 (h) The data required to be furnished under this section may
7-3 [also] be shared with [furnished only to:]
7-4 [(1)] cancer registries of health care facilities
7-5 subject to the confidentiality provisions in Section 82.009
7-6 [hospitals; and]
7-7 [(2) cancer registries of cancer treatment centers].
7-8 SECTION 6. Section 82.009, Health and Safety Code, is amended
7-9 to read as follows:
7-10 Sec. 82.009. CONFIDENTIALITY. (a) Reports, records, and
7-11 information [Data] obtained under this chapter are confidential and
7-12 are not subject to disclosure under Chapter 552, Government Code,
7-13 are not subject to subpoena, and may not otherwise be released or
7-14 made public except as provided by this section or Section
7-15 82.008(h). The reports, records, and information obtained under
7-16 this chapter are [directly from the medical records of a patient
7-17 is] for the confidential use of the department and the persons or
7-18 public or private entities that the department [board] determines
7-19 are necessary to carry out the intent of this chapter. [The data
7-20 is privileged and may not be divulged or made public in a manner
7-21 that discloses the identity of an individual whose medical records
7-22 have been used for obtaining data under this chapter.]
7-23 (b) Medical or epidemiological information may be released:
7-24 (1) for statistical purposes in a manner that prevents
7-25 identification of individuals, health care facilities, clinical
7-26 laboratories, or health care practitioners;
7-27 (2) with the consent of each person identified in the
8-1 information; or
8-2 (3) to promote cancer research, including release of
8-3 information to other cancer registries and appropriate state and
8-4 federal agencies, under rules adopted by the board to ensure
8-5 confidentiality as required by state and federal laws.
8-6 [Information that may identify an individual whose medical records
8-7 have been used for obtaining data under this chapter is not
8-8 available for public inspection under Chapter 552, Government
8-9 Code.]
8-10 (c) A state employee may not testify in a civil, criminal,
8-11 special, or other proceeding as to the existence or contents of
8-12 records, reports, or information concerning an individual whose
8-13 medical records have been used in submitting data required under
8-14 this chapter unless the individual consents in advance.
8-15 [Statistical information collected under this chapter is public
8-16 information.]
8-17 (d) Data furnished to a [hospital] cancer registry or a
8-18 cancer researcher [treatment center cancer registry] under
8-19 Subsection (b) or Section 82.008(h) [Section 82.008(e)] is for the
8-20 confidential use of the [hospital] cancer registry or the cancer
8-21 researcher [treatment center cancer registry], as applicable, and
8-22 is subject to Subsection (a).
8-23 SECTION 7. Section 82.010, Health and Safety Code, is amended
8-24 to read as follows:
8-25 Sec. 82.010. IMMUNITY FROM LIABILITY. The following persons
8-26 subject to this chapter that act in compliance with this chapter
8-27 are not civilly or criminally liable for furnishing the information
9-1 required under this chapter:
9-2 (1) a health care facility or [hospital,] clinical
9-3 laboratory[, or cancer treatment center];
9-4 (2) an administrator, officer, or employee of a health
9-5 care facility or [hospital,] clinical laboratory[, or cancer
9-6 treatment center]; [and]
9-7 (3) a health care practitioner or employee of a health
9-8 care practitioner; and
9-9 (4) an employee of the department [physician].
9-10 SECTION 8. This Act takes effect September 1, 2001.