By:  Gallegos                                                     S.B. No. 1113


A BILL TO BE ENTITLED

AN ACT

relating to allowing a hospital to release protected health 
information of a patient to emergency medical services providers 
for treatment, payment, and health care operations.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Section 241.153, Health and Safety Code, is 
amended to read as follows:
	Sec. 241.153.  DISCLOSURE WITHOUT WRITTEN AUTHORIZATION.  A 
patient's health care information may be disclosed without the 
patient's authorization if the disclosure is:
		(1)  directory information, unless the patient has 
instructed the hospital not to make the disclosure or the directory 
information is otherwise protected by state or federal law;
		(2)  to a health care provider who is rendering health 
care to the patient when the request for the disclosure is made;
		(3)  to a transporting emergency medical services 
provider for the [sole] purpose of:
			(A)  treatment or payment, as those terms are 
defined by the regulations adopted under the Health Insurance 
Portability and Accountability Act of 1996 (Pub. L. No. 104-191)
[determining the patient's diagnosis and the outcome of the 
patient's hospital admission]; or
			(B)  the following health care operations 
described by the regulations adopted under the Health Insurance 
Portability and Accountability Act of 1996 (Pub. L. No. 104–191):
				(i)  quality assessment and improvement 
activities;                
				(ii)  specified insurance functions;                                 
				(iii)  conducting or arranging for medical 
reviews; or             
				(iv)  competency assurance activities;                               
		(4)  to a member of the clergy specifically designated 
by the patient;      
		(5)  to a qualified organ or tissue procurement 
organization as defined in Section 692.002 for the purpose of 
making inquiries relating to donations according to the protocol 
referred to in Section 692.013(d);
		(6)  to a prospective health care provider for the 
purpose of securing the services of that health care provider as 
part of the patient's continuum of care, as determined by the 
patient's attending physician;
		(7)  to a person authorized to consent to medical 
treatment under Chapter 313 or to a person in a circumstance 
exempted from Chapter 313 to facilitate the adequate provision of 
treatment;
		(8)  to an employee or agent of the hospital who 
requires health care information for health care education, quality 
assurance, or peer review or for assisting the hospital in the 
delivery of health care or in complying with statutory, licensing, 
accreditation, or certification requirements and if the hospital 
takes appropriate action to ensure that the employee or agent:
			(A)  will not use or disclose the health care 
information for any other purpose; and
			(B)  will take appropriate steps to protect the 
health care information;   
		(9)  to a federal, state, or local government agency or 
authority to the extent authorized or required by law;
		(10)  to a hospital that is the successor in interest to 
the hospital maintaining the health care information;
		(11)  to the American Red Cross for the specific 
purpose of fulfilling the duties specified under its charter 
granted as an instrumentality of the United States government;
		(12)  to a regional poison control center, as the term 
is used in Chapter 777, to the extent necessary to enable the center 
to provide information and education to health professionals 
involved in the management of poison and overdose victims, 
including information regarding appropriate therapeutic use of 
medications, their compatibility and stability, and adverse drug 
reactions and interactions;
		(13)  to a health care utilization review agent who 
requires the health care information for utilization review of 
health care under Article 21.58A, Insurance Code;
		(14)  for use in a research project authorized by an 
institutional review board under federal law;
		(15)  to health care personnel of a penal or other 
custodial institution in which the patient is detained if the 
disclosure is for the sole purpose of providing health care to the 
patient;
		(16)  to facilitate reimbursement to a hospital, other 
health care provider, or the patient for medical services or 
supplies;
		(17)  to a health maintenance organization for purposes 
of maintaining a statistical reporting system as required by a rule 
adopted by a state agency or regulations adopted under the federal 
Health Maintenance Organization Act of 1973, as amended (42 U.S.C. 
Section 300 et seq.);
		(18)  to satisfy a request for medical records of a 
deceased or incompetent person pursuant to Section 74.051(e), Civil 
Practice and Remedies Code [4.01(e), Medical Liability and 
Insurance Improvement Act of Texas (Article 4590i, Vernon's Texas 
Civil Statutes)];
		(19)  to comply with a court order except as provided by 
Subdivision (20); or
		(20)  related to a judicial proceeding in which the 
patient is a party and the disclosure is requested under a subpoena 
issued under:
			(A)  the Texas Rules of Civil Procedure or Code of 
Criminal Procedure; or  
			(B)  Chapter 121, Civil Practice and Remedies 
Code.                        
	SECTION 2.  This Act takes effect September 1, 2005.