By:  Gallegos                                                     S.B. No. 1113
	(In the Senate - Filed March 8, 2005; March 21, 2005, read 
first time and referred to Committee on Health and Human Services; 
April 18, 2005, reported adversely, with favorable Committee 
Substitute by the following vote:  Yeas 9, Nays 0; April 18, 2005, 
sent to printer.)


COMMITTEE SUBSTITUTE FOR S.B. No. 1113                                   By:  Gallegos

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.
* * * * *