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A BILL TO BE ENTITLED
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AN ACT
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relating to data collection at the Department of State Health |
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Services. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. The heading to Chapter 108, Health and Safety |
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Code, is amended to read as follows: |
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CHAPTER 108. TEXAS HEALTH CARE INFORMATION COLLECTION PROGRAM |
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[COUNCIL] |
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SECTION 2. Section 108.001, Health and Safety Code, is |
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amended to read as follows: |
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Sec. 108.001. TEXAS HEALTH CARE INFORMATION COLLECTION |
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PROGRAM [CREATION OF COUNCIL]. The Department of State [Texas] |
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Health Services [Care Information Council] shall administer this |
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chapter and report to the governor, the legislature, and the |
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public. |
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SECTION 3. Section 108.002, Health and Safety Code, is |
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amended by amending Subdivisions (1), (3), (5), (6), (7), (8), |
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(12), (16), (17), (20), (21), and (22) and adding Subdivisions |
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(4-a), (8-a), (11-a), (14-a), (17-a), and (21-a) to read as |
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follows: |
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(1) "Accurate and consistent data" means data that has |
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been edited by the department [council] and subject to provider |
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validation and certification. |
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(3) "Certification" means the process by which a |
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provider confirms the accuracy and completeness of the data set |
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required to produce the public use data file in accordance with |
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department [council] rule. |
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(4-a) "Commission" means the Health and Human Services |
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Commission. |
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(5) "Confidential data" means data that is made |
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confidential under this chapter, other state law, or federal |
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law ["Council" means the Texas Health Care Information Council]. |
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(6) "Data" means the material or collection of facts |
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on which a discussion or an inference is based [information
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collected under Section 108.0065 or 108.009 in the form initially
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received]. |
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(7) "Department" means the [Texas] Department of State |
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Health Services. |
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(8) "Edit" means to use an electronic standardized |
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process developed and implemented by the department [council rule] |
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to identify potential errors and mistakes in data elements by |
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reviewing data fields for the presence or absence of data and the |
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accuracy and appropriateness of data. |
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(8-a) "Executive commissioner" means the executive |
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commissioner of the Health and Human Services Commission. |
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(11-a) "Health practitioner" means an individual |
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licensed under the laws of this state to practice chiropractic, |
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dentistry, nursing, podiatry, or psychology under Title 3, |
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Occupations Code. |
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(12) "Hospital" means a public, for-profit, or |
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nonprofit institution licensed or owned by this state that is a |
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general or special hospital, private mental hospital, [chronic
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disease hospital,] or other type of hospital. |
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(14-a) "Program director" means the primary |
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department employee responsible for performing the functions and |
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exercising the authority of the program director and includes the |
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program director's designee. |
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(16) "Provider quality" means the extent to which a |
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provider renders care that, within the capabilities of modern |
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health profession disciplines [medicine], obtains for patients |
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[medically] acceptable health outcomes and prognoses, after risk |
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[severity] adjustment. |
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(17) "Public use data" means patient level data |
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relating to individual hospitalizations that has [not been
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summarized or analyzed, that has] had patient identifying |
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information removed, that identifies physicians and health |
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practitioners only by use of uniform physician or health |
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practitioner identifiers, and that is [severity and risk adjusted,] |
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edited[,] and verified for accuracy and consistency. Public use |
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data may exclude some data elements submitted to the department |
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[council]. Public use data does not include confidential data. |
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(17-a) "Risk adjustment" means a process applied to |
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data to allow for statistical comparisons between providers to |
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statistically control for different risk factors in patients that |
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may affect their health care outcomes. |
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(20) "Uniform patient identifier" means an identifier |
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[a number] assigned by the department [council] to an individual |
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patient and composed of numeric, alpha, or alphanumeric characters. |
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(21) "Uniform physician or health practitioner |
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identifier" means an identifier [a number] assigned by the |
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department [council] to an individual physician or health |
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practitioner and composed of numeric, alpha, or alphanumeric |
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characters. |
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(21-a) "Utilization report" means a provider level |
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report of aggregate data prepared to the specifications of a |
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requestor in which the state expresses no finding or opinion. |
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(22) "Validation" means the process that [by which a
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provider] verifies the accuracy and completeness of data and |
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corrects any errors identified before certification in accordance |
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with department [council] rule. |
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SECTION 4. Chapter 108, Health and Safety Code, is amended |
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by adding Section 108.0055 to read as follows: |
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Sec. 108.0055. POWERS AND DUTIES OF EXECUTIVE COMMISSIONER. |
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The executive commissioner shall adopt rules necessary to |
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administer this chapter. |
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SECTION 5. Section 108.006, Health and Safety Code, is |
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amended to read as follows: |
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Sec. 108.006. POWERS AND DUTIES OF DEPARTMENT [COUNCIL]. |
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(a) The department [council] shall develop a statewide health care |
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data collection system to collect health care charges, utilization |
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data, provider quality reports [data], and outcome data to |
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facilitate the promotion and accessibility of cost-effective, good |
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quality health care. The department [council] shall: |
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(1) direct the collection, dissemination, and |
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analysis of data under this chapter; |
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(2) [contract with the department to collect the data
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under this chapter;
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[(3)] adopt policies and recommend rules necessary to |
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carry out this chapter, including rules concerning data collection |
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requirements; |
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(3) [(4)] build on and not duplicate other data |
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collection required by state or federal law[, by an accreditation
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organization,] or by executive commissioner [board] rule; |
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(4) [(5)] working with appropriate agencies, review |
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public health data collection programs in this state and recommend, |
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where appropriate, consolidation of the programs and any |
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legislation necessary to effect the consolidation or obtain data |
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collected by other state agencies; |
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(5) [(6)] assure that public use data is made |
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available and accessible to interested persons; |
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(6) recommend rules regarding [(7)
prescribe by
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rule] the process for providers to submit data consistent with |
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Section 108.009; |
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(7) [(8)
adopt by rule and implement a methodology to
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collect and disseminate data reflecting provider quality in
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accordance with Section 108.010;
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[(9)] make annual reports to the legislature, the |
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governor, and the public on: |
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(A) the charges and rate of change in the charges |
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for health care services in this state; |
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(B) the effectiveness of the department |
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[council] in carrying out the legislative intent of this chapter; |
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(C) if applicable, any recommendations on the |
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need for further legislation; and |
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(D) the quality and effectiveness of health care |
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and access to health care for all citizens of this state; |
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(8) [(10)] develop an annual work plan and establish |
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priorities to accomplish its duties; |
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(9) [(11)] provide consumer education on the |
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interpretation and understanding of the public use data or provider |
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quality reports [data] before the data or reports are [is] |
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disseminated to the public; |
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(10) [(12)] work with the commission [Health and Human
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Services Commission] and each health and human services agency that |
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administers a part of the state Medicaid program to avoid |
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duplication of expenditures of state funds for computer systems, |
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staff, or services in the collection and analysis of data relating |
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to the state Medicaid program; and |
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(11) provide data and [(13)
work with the Department
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of Information Resources in developing and implementing the
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statewide health care data collection system and maintain
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consistency with Department of Information Resources standards;
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and
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[(14) develop and implement a health care] information |
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[plan] to be used by the department to: |
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(A) support public health and preventative |
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health initiatives; |
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(B) assist in the delivery of primary and |
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preventive health care services; |
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(C) facilitate the establishment of appropriate |
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benchmark data to measure performance improvements; |
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(D) establish and maintain a systematic approach |
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to the collection, storage, and analysis of health care data for |
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longitudinal, epidemiological, and policy impact studies; and |
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(E) develop and use system-based protocols to |
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identify individuals and populations at risk. |
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(b) The department [council] may recommend[:
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[(1)
employ or contract with the department to employ
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an executive director and other staff, including administrative
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personnel, necessary to comply with this chapter and rules adopted
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under this chapter;
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[(2)
engage professional consultants as it considers
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necessary to the performance of its duties;
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[(3) adopt] rules clarifying which health care |
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facilities must provide data under this chapter[; and
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[(4)
apply for and receive any appropriation,
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donation, or other funds from the state or federal government or any
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other public or private source, subject to Section 108.015 and
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limitations and conditions provided by legislative appropriation]. |
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(c) The department [council] may not establish or recommend |
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rates of payment for health care services. |
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[(d)
The council may not take an action that affects or
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relates to the validity, status, or terms of an interagency
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agreement or a contract with the department without the board's
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approval.] |
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(e) In the collection of data, the department [council] |
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shall consider the research and initiatives being pursued by the |
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United States Department of Health and Human Services, the National |
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Committee for Quality Assurance, and the Joint Commission on |
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Accreditation of Healthcare Organizations to reduce potential |
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duplication or inconsistencies. The executive commissioner |
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[council] may not adopt rules that conflict with or duplicate any |
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federally mandated data collection programs or requirements of |
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comparable scope. |
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(f) The department [council] shall recommend rules on |
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[prescribe by rule] a public use data element list [file minimum
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data set] that maintains patient confidentiality and establishes |
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data accuracy and consistency. |
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(g) The public use data element list [file minimum data set] |
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as defined by [council] rule is subject to annual review by the |
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department [council with the assistance of the advisory committee
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under Section 108.003(g)(5). The purpose of the review is] to |
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evaluate requests to modify the existing public use [minimum] data |
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element list [set] and editing process of those data elements. A |
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decision to modify the public use [minimum] data element list [set] |
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by the addition or deletion of data elements shall include |
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consideration of the value of the specific data to be added or |
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deleted and the technical feasibility of establishing data accuracy |
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and consistency. The department [council] may also consider the |
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costs to the department [council] and providers associated with |
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modifying the public use [minimum] data element list [set]. |
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(h) In accordance with Sections 108.013(k), (l), (m), and |
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(n) and [Section] 108.0135, the department [council] may release |
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data collected under Section 108.009 that is not included in the |
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public use data element list [file minimum data set] established |
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under this chapter [Subsection (f)]. |
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SECTION 6. Section 108.007, Health and Safety Code, is |
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amended to read as follows: |
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Sec. 108.007. REVIEW POWERS. (a) The [council, through
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the] department, [and] subject to reasonable rules and guidelines, |
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may: |
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(1) inspect documents and records used by data sources |
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that are required to compile data and reports; and |
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(2) compel providers to produce accurate documents and |
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records. |
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(b) The department [council] may enter into a memorandum of |
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understanding with a state agency[, including the division of the
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Health and Human Services Commission responsible for the state
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Medicaid program,] or with a school of public health or another |
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institution of higher education[,] to share data and expertise, to |
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obtain data for the department [council], or to make data available |
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to the department [council]. An agreement entered into under this |
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subsection must protect patient confidentiality. |
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SECTION 7. Section 108.009, Health and Safety Code, is |
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amended to read as follows: |
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Sec. 108.009. DATA SUBMISSION AND COLLECTION. (a) The |
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department [council] may collect, and, except as provided by |
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Subsections (c) and (d), providers shall submit to the department |
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[council] or another entity as determined by the department |
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[council], all data required by this section or by rule. The data |
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shall be collected according to uniform submission formats, coding |
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systems, and other technical specifications necessary to make the |
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incoming data substantially valid, consistent, compatible, and |
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manageable using electronic data processing, if available. |
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(b) The department [council] shall recommend [adopt] rules |
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to implement the data submission requirements imposed by Subsection |
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(a) in appropriate stages to allow for the development of efficient |
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systems for the collection and submission of the data. A rule |
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[adopted by the council] that requires submission of a data element |
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that, before adoption of the rule, was not required to be submitted |
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may not take effect before the 90th day after the date the rule is |
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adopted and must take effect not later than the first anniversary |
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after the date the rule is adopted. |
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(c) A rural provider may, but is not required to, provide |
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the data required by this chapter. A hospital may, but is not |
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required to, provide the data required by this chapter if the |
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hospital: |
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(1) is exempt from state franchise, sales, ad valorem, |
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or other state or local taxes; and |
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(2) does not seek or receive reimbursement for |
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providing health care services to patients from any source, |
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including: |
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(A) the patient or any person legally obligated |
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to support the patient; |
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(B) a third-party payor; or |
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(C) Medicaid, Medicare, or any other federal, |
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state, or local program for indigent health care. |
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(d) The department [council] may not collect data from |
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individual physicians or health practitioners or from an entity |
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that is composed entirely of physicians or health practitioners and |
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that is a professional association organized under the Texas |
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Professional Association Act (Article 1528f, Vernon's Texas Civil |
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Statutes) or formed under the Texas Professional Association Law, |
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as described by Section 1.008, Business Organizations Code, a |
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limited liability partnership organized under Section 3.08, Texas |
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Revised Partnership Act (Article 6132b-3.08, Vernon's Texas Civil |
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Statutes), or described by Subchapter J, Chapter 152, Business |
|
Organizations Code, or a limited liability company organized under |
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the Texas Limited Liability Company Act (Article 1528n, Vernon's |
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Texas Civil Statutes) or formed under the Texas Limited Liability |
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Company Law, as described by Section 1.008, Business Organizations |
|
Code, except to the extent the entity owns and operates a health |
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care facility in this state. This subsection does not prohibit the |
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release of data about physicians or health practitioners using |
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uniform physician or health practitioner identifiers that has been |
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collected from a health care facility under this chapter. |
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[(e)
The council shall establish the department as the
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single collection point for receipt of data from providers. With
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the approval of the council and the board, the department may
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transfer collection of any data required to be collected by the
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department under any other law to the statewide health care data
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collection system.] |
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(f) The department [council] may not require providers to |
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submit data more frequently than quarterly, but providers may |
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submit data on a more frequent basis. |
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(g) The department may [council shall] coordinate data |
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collection with the data collection formats used by federally |
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qualified health centers. To satisfy the requirements of this |
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chapter: |
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(1) a federally qualified health center shall submit |
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annually to the department [council] a copy of the Medicaid cost |
|
report of federally qualified health centers; and |
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(2) a provider receiving federal funds under 42 U.S.C. |
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Section 254b, 254c, or 256 shall submit annually to the department |
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[council] a copy of the Bureau of Common Reporting Requirements |
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data report developed by the United States Public Health Service. |
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(h) The department [council] shall coordinate data |
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collection with the data submission formats used by hospitals and |
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other providers. The department [council] shall accept data in the |
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format developed by the American National Standards Institute |
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[National Uniform Billing Committee (Uniform Hospital Billing Form
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UB 92) and HCFA-1500] or its [their] successors or other nationally |
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[universally] accepted standardized format or forms that hospitals |
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and other providers use for other complementary purposes. |
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(i) The department [council] shall recommend rules on |
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[develop by rule] reasonable alternate data submission procedures |
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for providers that do not possess electronic data processing |
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capacity to create electronic claims. |
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(k) The department [council] shall collect health care data |
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elements relating to payer type, the racial and ethnic background |
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of patients, and the use of health care services by consumers. |
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(m) To the extent feasible, the department [council] shall |
|
obtain from public records the information that is available from |
|
those records. |
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(o) A provider of a health benefit plan shall annually |
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submit to the department [council] aggregate data by service area |
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required by the Health Plan Employer Data Information Set (HEDIS) |
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data as operated by the National Committee for Quality Assurance. |
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The department [council] may approve the submission of data in |
|
accordance with other methods generally used by the health benefit |
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plan industry. If the Health Plan Employer Data Information Set |
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does not generally apply to a health benefit plan, the department |
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[council] shall require submission of data in accordance with other |
|
methods. This subsection does not relieve a health care facility |
|
that provides services under a health benefit plan from the |
|
requirements of this chapter. Information submitted under this |
|
section is subject to Sections [Section] 108.011 and 108.013(k), |
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(l), (m), and (n), but is not subject to Section 108.010. |
|
SECTION 8. Chapter 108, Health and Safety Code, is amended |
|
by adding Section 108.0095 to read as follows: |
|
Sec. 108.0095. CHANGE IN OWNERSHIP BY ENTITY REQUIRED TO |
|
SUBMIT DATA. An entity that acquires, by merger, acquisition, or |
|
other transfer, ownership of a health care facility or an |
|
organization that owns or operates a health benefit plan that is |
|
required to submit data under this chapter shall report the change |
|
in ownership to the department. |
|
SECTION 9. Section 108.010, Health and Safety Code, is |
|
amended to read as follows: |
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Sec. 108.010. [COLLECTION AND] DISSEMINATION OF PROVIDER |
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QUALITY REPORTS [DATA]. (a) Subject to Section 108.009, the |
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department [council] shall gather [collect] data reflecting |
|
provider quality and shall produce provider quality reports based |
|
on a methodology and review process established through the |
|
executive commissioner's [council's] rulemaking process. The |
|
methodology shall identify and measure quality standards and adhere |
|
to any federal mandates. |
|
[(b)
The council shall study and analyze initial
|
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methodologies for obtaining provider quality data, including
|
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outcome data.] |
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(c) The department [council] shall test each initial |
|
provider quality report [the] methodology for a period of time to be |
|
determined by the department [by collecting provider quality data
|
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for one year, subject to Section 108.009]. This requirement to test |
|
a methodology applies only to methodologies that have not |
|
previously been used by the department. The department [council] |
|
may test using pilot methodologies. Any [After collecting provider
|
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quality data for one year, the council shall report findings
|
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applicable to a provider to that provider and allow the provider to
|
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review and comment on the initial provider quality data applicable
|
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to that provider. The council shall verify the accuracy of the data
|
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during this review and revision process. After the review and
|
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revision process,] provider quality [data for subsequent] reports |
|
shall be published and made available to the public, on a time |
|
schedule the department [council] considers appropriate. |
|
(d) If the department [council] determines that a provider |
|
quality report [data] to be published under Subsection (c) does not |
|
provide the intended result or is inaccurate or inappropriate for |
|
dissemination, the department [council] is not required to publish |
|
or release the report [data or reports based in whole or in part on
|
|
the data]. This subsection does not affect the release of public |
|
use data in accordance with Section 108.011 or utilization reports |
|
requested under Chapter 552, Government Code [the release of
|
|
information submitted under Section 108.009(o)]. |
|
(e) The department shall allow [council shall adopt rules
|
|
allowing] a provider to submit concise written comments regarding |
|
any specific provider quality report [data] to be released |
|
concerning the provider. The department [council] shall make the |
|
comments available to the public at the department [office of the
|
|
council] and in an electronic form accessible through the Internet. |
|
The comments shall be attached to any public release of a provider |
|
quality report [data]. Providers shall submit the comments to the |
|
department [council] to be attached to the public release of a |
|
provider quality report [data] in the same format as the provider |
|
quality report [data] that is to be released. |
|
(f) The methodology adopted by the department [council] for |
|
measuring quality shall include one or more adjustment methods, |
|
such as case-mix qualifiers, risk adjustment factors, severity |
|
adjustment factors, adjustments for medical education and |
|
research, or [and] any other factors necessary to accurately |
|
reflect provider quality. |
|
(g) In addition to the requirements of this section, any |
|
release of provider quality reports [data] shall comply with |
|
Section 108.011(f) [Sections 108.011(e) and (f)]. |
|
(h) A provider quality [data] report may not identify an |
|
individual physician or health practitioner by name, but must |
|
identify the physician by the uniform physician or health |
|
practitioner identifier designated by the department [council] |
|
under Section 108.011(c). |
|
(i) The department may [council shall] release utilization |
|
reports without the review and comment by any provider [quality
|
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data in an aggregate form without uniform physician identifiers
|
|
when:
|
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[(1)
the data relates to providers described by
|
|
Section 108.0025(1); or
|
|
[(2)
the cell size of the data is below the minimum
|
|
size established by council rule that would enable identification
|
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of an individual patient or physician]. |
|
SECTION 10. Section 108.011, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 108.011. DISSEMINATION OF PUBLIC USE DATA AND |
|
DEPARTMENT [COUNCIL] PUBLICATIONS. (a) The department [council] |
|
shall promptly provide public use data and data collected in |
|
accordance with Section 108.009(o) to those requesting it. The |
|
public use data does not include [provider quality data prescribed
|
|
by Section 108.010 or] confidential data prescribed by Section |
|
108.013. |
|
(b) Subject to the restrictions on access to department |
|
[council] data prescribed by Section [Sections 108.010 and] |
|
108.013, and using the public use data and other data, records, and |
|
matters of record available to it, the department [council] shall |
|
prepare and issue reports to the governor, the legislature, and the |
|
public as provided by this section and Section 108.006(a). The |
|
department [council] must issue the reports at least annually. |
|
(c) Subject to the restrictions on access to department |
|
[council] data prescribed by Section [Sections 108.010 and] |
|
108.013, the department [council] shall use public use data to |
|
prepare and issue reports that provide information relating to |
|
providers, such as the incidence rate of selected medical or |
|
surgical procedures. The reports must provide the data in a manner |
|
that identifies individual providers, including individual |
|
physicians, and that identifies and compares data elements for all |
|
providers. Individual physicians or health practitioners may not |
|
be identified by name, but shall be identified by uniform physician |
|
or health practitioner identifiers. The department [council by
|
|
rule] shall recommend rules and designate the characters to be used |
|
as uniform physician or health practitioner identifiers. |
|
(c-1) The department [council] shall use public use data to |
|
prepare and issue reports that provide information for review and |
|
analysis by the commission [Health and Human Services Commission] |
|
relating to services that are provided in a niche hospital, as |
|
defined by Section 105.002, Occupations Code, and that are provided |
|
by a physician with an ownership interest in the niche hospital. |
|
(c-2) Subsection (c-1) does not apply to an ownership |
|
interest in publicly available shares of a registered investment |
|
company, such as a mutual fund, that owns publicly traded equity |
|
securities or debt obligations issued by a niche hospital or an |
|
entity that owns the niche hospital. |
|
(d) The department [council] shall adopt procedures to |
|
establish the accuracy and consistency of the public use data |
|
before releasing the public use data to the public. |
|
(e) If public use data is requested from the department |
|
[council] about a specific provider, the department [council] shall |
|
notify the provider about the release of the data. This subsection |
|
does not authorize the provider to interfere with the release of |
|
that data. |
|
(f) A report issued by the department [council] shall |
|
include a reasonable review [and comment] period for the affected |
|
providers before public release of the report. |
|
(g) The department [council] shall provide a process [adopt
|
|
rules] allowing a provider to submit concise written comments |
|
regarding any specific public use data to be released concerning |
|
the provider. The department [council] shall make the comments |
|
available to the public [and the office of the council] and in an |
|
electronic form accessible through the Internet. The comments |
|
shall be attached to any public release of the public use data. |
|
Providers shall submit the comments to the department [council] to |
|
be attached to the public release of public use data in the same |
|
format as the public use data that is to be released. |
|
(h) Media devices [Tapes] containing public use data and |
|
provider quality reports that are released to the public must |
|
include general consumer education material, including an |
|
explanation of the benefits and limitations of the information |
|
provided in the public use data and provider quality reports. |
|
(i) The department [council] shall release public use data |
|
[in an aggregate form] without uniform physician or health |
|
practitioner identifiers when: |
|
(1) the data relates to providers described by Section |
|
108.0025(1); or |
|
(2) the [cell size of the] data [is below the minimum
|
|
size established by council rule that] would enable easy |
|
identification of an individual patient, [or] physician, or health |
|
practitioner when combined with other data elements from the public |
|
use data element list. |
|
(j) Notwithstanding Section 552.021 or 552.221, Government |
|
Code, the department is not required to make data available or |
|
produce data for inspection or duplication under Chapter 552, |
|
Government Code, until the program director has verified the data |
|
as reasonably accurate. |
|
SECTION 11. Section 108.012, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 108.012. COMPUTER ACCESS TO DATA. (a) The department |
|
[council] shall provide a means for computer |
|
[computer-to-computer] access to the public use data. All data and |
|
reports shall maintain patient confidentiality as provided by |
|
Section 108.013. |
|
(b) The department [council] may charge a person requesting |
|
public use data or data used in provider quality reports [data] a |
|
fee for the data. The fees may reflect the quantity of information |
|
provided and the expense incurred by the department [council] in |
|
collecting and providing the data [and shall be set at a level that
|
|
will raise revenue sufficient for the operation of the council. The
|
|
council may not charge a fee for providing public use data to
|
|
another state agency]. |
|
SECTION 12. Section 108.013, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 108.013. CONFIDENTIALITY AND GENERAL ACCESS TO DATA. |
|
(a) The data received by the department [council] shall be used by |
|
the department [council] for the benefit of the public. [Subject to
|
|
specific limitations established by this chapter and council rule,
|
|
the council shall make determinations on requests for information
|
|
in favor of access.] |
|
(b) The department [council by rule] shall designate the |
|
characters to be used as uniform patient and physician or health |
|
practitioner identifiers. The basis for assignment of the |
|
characters and the manner in which the characters are assigned are |
|
confidential. |
|
(c) Unless specifically authorized by this chapter, the |
|
department [council] may not release and a person or entity may not |
|
gain access to any data: |
|
(1) that could reasonably be expected to reveal the |
|
identity of a patient; |
|
(2) that could reasonably be expected to reveal the |
|
identity of a physician or health practitioner; |
|
(3) disclosing provider discounts or differentials |
|
between payments and billed charges; |
|
(4) relating to actual payments to an identified |
|
provider made by a payer; or |
|
(5) submitted to the department [council] in a uniform |
|
submission format that is not included in the public use data |
|
element list described by [set established under] Sections |
|
108.006(f) and (g), except in accordance with Subsections (k), (l), |
|
(m), and (n) and Section 108.0135. |
|
(d) All data collected and used by the department [and the
|
|
council] under this chapter is subject to the confidentiality |
|
provisions and criminal penalties of: |
|
(1) Section 311.037; |
|
(2) Section 81.103; and |
|
(3) Section 159.002, Occupations Code. |
|
(e) Data on patients and compilations produced from the data |
|
collected that identify patients are not: |
|
(1) subject to discovery, subpoena, or other means of |
|
legal compulsion for release to any person or entity except as |
|
provided by this section; or |
|
(2) admissible in any civil, administrative, or |
|
criminal proceeding. |
|
(f) Data on physicians or health practitioners and |
|
compilations produced from the data collected that identify |
|
physicians or health practitioners are not: |
|
(1) subject to discovery, subpoena, or other means of |
|
legal compulsion for release to any person or entity except as |
|
provided by this section; or |
|
(2) admissible in any civil, administrative, or |
|
criminal proceeding. |
|
(g) The department [council] may not release data elements |
|
in a manner that will reveal the identity of a patient. The |
|
department [council] may not release data elements in a manner that |
|
will reveal the identity of a physician or health practitioner. |
|
(h) Subsections (c) and (g) do not prohibit the release of a |
|
uniform physician or health practitioner identifier in conjunction |
|
with associated public use data in accordance with Section 108.011 |
|
or a provider quality report in accordance with Section 108.010. |
|
(i) Notwithstanding any other law, the [council and the] |
|
department may not provide information made confidential by this |
|
section to any other agency of this state. |
|
(j) The department [council] shall recommend a [by] rule to |
|
[, with the assistance of the advisory committee under Section
|
|
108.003(g)(5),] develop and implement a mechanism to comply with |
|
Subsections (c)(1) and (2). |
|
(k) The department may disclose data collected under this |
|
chapter that is not included in public use data to any program |
|
within the department upon review and approval by the institutional |
|
or other review board established under Section 108.0135. This |
|
subsection does not authorize disclosure of physician and health |
|
care practitioner identifying data. |
|
(l) The department shall implement safeguards to ensure |
|
that the department maintains the confidentiality of confidential |
|
data in the possession of the department. The department shall |
|
identify the confidential data to a program within the department |
|
receiving the data as described by Subsection (k). The program |
|
receiving the data must ensure that the confidential data remains |
|
confidential. |
|
(m) Notwithstanding other law, the confidential data |
|
collected under this chapter that is disclosed to another program |
|
within the department under this section remains subject to the |
|
confidentiality provisions of this chapter. |
|
(n) Subsections (c), (d), and (g) and Sections 108.010(g) |
|
and (h) and 108.011(e) and (f) do not apply to the disclosure of |
|
data to a department program with respect to which the department is |
|
given approval to disclose data under this section. This |
|
subsection does not authorize disclosure of physician and health |
|
care practitioner identifying data. |
|
SECTION 13. Section 108.0135, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 108.0135. INSTITUTIONAL [SCIENTIFIC] REVIEW BOARD |
|
[PANEL]. (a) The department [council] shall establish a |
|
department institutional review board or similar privacy board |
|
[scientific review panel] to review and approve valid requests for |
|
access to data not contained in the [information other than] public |
|
use data element list established by rule, excluding the names and |
|
identification numbers of the patients, physicians, and health |
|
practitioners. The members of the board [panel] shall have |
|
experience and expertise in ethics, patient confidentiality, and |
|
health care data. |
|
(b) For purposes of Subsection (a), an identification |
|
number is any unique identifier composed of numeric, alpha, or |
|
alphanumeric characters assigned by a person to the patient, |
|
physician, or health care practitioner, but does not include a |
|
uniform identifier assigned by the department under this chapter |
|
[To assist the panel in determining whether to approve a request for
|
|
information, the council shall adopt rules similar to the federal
|
|
Health Care Financing Administration's guidelines on releasing
|
|
data]. |
|
[(c)
A request for information other than public use data
|
|
must be made on the form created by the council.] |
|
SECTION 14. Subsections (b), (c), and (d), Section 108.014, |
|
Health and Safety Code, are amended to read as follows: |
|
(b) A person who fails to supply available data under this |
|
chapter [Sections 108.009 and 108.010] is liable for a civil |
|
penalty of not less than $500 [$1,000 or more than $10,000] for each |
|
day after the date of the last day on which the entity may timely |
|
submit the data. In determining the amount of the civil penalty, |
|
the court shall consider: |
|
(1) the person's previous violations; |
|
(2) the seriousness [act] of the violation, including |
|
the nature, circumstances, extent, and gravity of the violation; |
|
(3) whether the health and safety of the public was |
|
threatened by the violation; |
|
(4) the demonstrated good faith of the person; and |
|
(5) the amount necessary to deter future violations. |
|
(c) The attorney general, at the request of the department |
|
[council], shall enforce this chapter. The venue of an action |
|
brought under this section is in Travis County. |
|
(d) A civil penalty recovered in a suit instituted by the |
|
attorney general under this chapter shall be deposited in the |
|
general revenue fund and may be appropriated to [the credit of] the |
|
department [health care information account]. |
|
SECTION 15. Chapter 108, Health and Safety Code, is amended |
|
by adding Sections 108.0142 and 108.0143 to read as follows: |
|
Sec. 108.0142. INJUNCTION. (a) The department may bring |
|
an action for an injunction or other process against a person who |
|
knowingly or negligently releases data in violation of this chapter |
|
or who fails to file data or reports required by this chapter. |
|
(b) The district court may grant any prohibitory or |
|
mandatory relief warranted by the facts, including a temporary |
|
restraining order, temporary injunction, or permanent injunction. |
|
Sec. 108.0143. REMEDIES CUMULATIVE. The civil penalty and |
|
injunction authorized by this chapter are in addition to any other |
|
civil, administrative, or criminal action provided by law. |
|
SECTION 16. Subsection (b), Section 531.021, Government |
|
Code, is amended to read as follows: |
|
(b) The commission shall: |
|
(1) plan and direct the Medicaid program in each |
|
agency that operates a portion of the Medicaid program, including |
|
the management of the Medicaid managed care system and the |
|
development, procurement, management, and monitoring of contracts |
|
necessary to implement the Medicaid managed care system; |
|
(2) adopt reasonable rules and standards governing the |
|
determination of fees, charges, and rates for medical assistance |
|
payments under Chapter 32, Human Resources Code, in consultation |
|
with the agencies that operate the Medicaid program; and |
|
(3) establish requirements for and define the scope of |
|
the ongoing evaluation of the Medicaid managed care system |
|
conducted in conjunction with the Texas Health Care Information |
|
Collection Program [Council] under Chapter 108 [Section 108.0065], |
|
Health and Safety Code. |
|
SECTION 17. Section 2054.0541, Government Code, is amended |
|
to read as follows: |
|
Sec. 2054.0541. STATEWIDE HEALTH CARE DATA COLLECTION |
|
SYSTEM. The department shall assist the [Texas Health Care
|
|
Information Council and the Texas] Department of State Health |
|
Services with planning, analyses, and management functions |
|
relating to the procurement, use, and implementation of a statewide |
|
health care data collection system under Chapter 108, Health and |
|
Safety Code. |
|
SECTION 18. Subsection (b), Section 501.253, Insurance |
|
Code, is amended to read as follows: |
|
(b) The department and the Department of State Health |
|
Services [Texas Health Care Information Council] shall provide any |
|
information or data as requested by the office in furtherance of the |
|
duties under this subchapter. |
|
SECTION 19. The following provisions of the Health and |
|
Safety Code are repealed: |
|
(1) Subdivision (2), Section 108.002; |
|
(2) Section 108.003; |
|
(3) Section 108.004; |
|
(4) Section 108.0045; |
|
(5) Section 108.005; |
|
(6) Section 108.0062; |
|
(7) Section 108.0065; |
|
(8) Section 108.008; |
|
(9) Section 108.0081; |
|
(10) Section 108.0085; and |
|
(11) Section 108.015. |
|
SECTION 20. A reference in law to the Texas Health Care |
|
Information Council means the Texas Health Care Information |
|
Collection Program. |
|
SECTION 21. This Act takes effect September 1, 2007. |
|
|
|
* * * * * |