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A BILL TO BE ENTITLED
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AN ACT
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relating to the exchange of secure electronic health information |
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between the Health and Human Services Commission and local or |
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regional health information exchanges and the development of a |
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health passport for Medicaid recipients. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter B, Chapter 531, Government Code, is |
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amended by adding Section 531.02416 to read as follows: |
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Sec. 531.02416. ELECTRONIC HEALTH INFORMATION EXCHANGE |
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PROCEDURES. (a) The commission shall establish procedures for the |
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exchange of secure electronic health information between the |
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commission and local or regional health information exchanges. |
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(b) A local or regional health information exchange that |
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exchanges electronic health information under this section must |
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possess a functioning health information exchange database that |
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exchanges secure electronic health information among hospitals, |
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clinics, physicians' offices, and other health care providers that |
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are not each owned by a single entity or included in a single |
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operational unit or network. The information exchanged by the |
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local or regional health information exchange must include health |
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information for patients receiving services from state and federal |
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health and human services programs administered by the commission. |
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(c) In developing procedures under this section, the |
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commission shall: |
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(1) establish specific written guidelines, in |
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conjunction with interested health information exchanges, |
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specifying which health care providers will use which data elements |
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obtained from the commission and for what purposes, including |
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purposes related to reducing costs, improving access, and improving |
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quality of care for patients; and |
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(2) ensure compliance with all state and federal laws |
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and rules related to the transmission of health information, |
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including state privacy laws and the Health Insurance Portability |
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and Accountability Act of 1996 (42 U.S.C. Section 1320d et seq.) and |
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rules adopted under that Act. |
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(d) The procedures under this section must at a minimum |
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address the exchange of a patient's medication history. The |
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procedures may also address the exchange of additional health care |
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information. |
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SECTION 2. Subchapter B, Chapter 531, Government Code, is |
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amended by adding Section 531.096 to read as follows: |
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Sec. 531.096. HEALTH PASSPORT. (a) The commission, with |
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the assistance of physicians and other health care providers |
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experienced with the use of electronic health records, shall |
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develop and provide a health passport for each person who: |
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(1) is receiving medical assistance under the state |
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Medicaid program through a managed care plan, as defined by Section |
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533.001; and |
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(2) is not provided a health passport under another |
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law of this state. |
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(a-1) Notwithstanding Subsection (a), the commission is not |
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required to provide a health passport for each person described by |
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that subsection until September 1, 2014. Beginning as soon as |
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feasible after September 1, 2009, the commission shall provide a |
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health passport to each child entitled to a health passport under |
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Subsection (a), or if initial provision of health passports to all |
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children is impossible, to selected categories of children. |
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Thereafter, at intervals occurring as soon as possible, the |
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commission shall expand the provision of health passports to |
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additional children and finally to adults. This subsection expires |
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September 1, 2014. |
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(b) Information that is accessible through the health |
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passport provided under this section must be maintained in an |
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electronic format that uses the commission's existing computer |
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resources to the greatest extent possible. |
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(c) The executive commissioner shall adopt rules specifying |
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the information required to be included in the health passport. The |
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required information may include: |
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(1) the name and address of each of the person's |
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physicians and health care providers; |
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(2) a record of each visit to a physician or other |
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health care provider, including routine checkups; |
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(3) an immunization record; |
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(4) a list of the person's known health problems and |
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allergies; |
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(5) information on all medications prescribed to the |
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person in adequate detail to permit refills of prescriptions, |
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including the disease or condition that each medication treats; and |
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(6) any other available health history that physicians |
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and other health care providers who provide care for the person |
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determine is important. |
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(d) The system used to access the health passport must be |
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secure and maintain the confidentiality of the person's health |
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records. To the extent that this section authorizes the use or |
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disclosure of protected health information by a covered entity, as |
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those terms are defined by the privacy rule of the Administrative |
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Simplification subtitle of the Health Insurance Portability and |
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Accountability Act of 1996 (Pub. L. No. 104-191) contained in 45 |
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C.F.R. Part 160 and 45 C.F.R. Part 164, Subparts A and E, the |
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covered entity shall ensure that the use or disclosure complies |
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with all applicable requirements, standards, or implementation |
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specifications of the privacy rule. |
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(e) The commission shall provide training or instructional |
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materials regarding use of a health passport to adults who receive |
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health passports, parents, guardians, and caretakers of children |
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who receive health passports, physicians, and other health care |
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providers. |
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(f) The commission shall make health passport information |
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available in printed and electronic formats to the following |
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individuals when a person loses eligibility for Medicaid, unless |
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the commission is required to provide a health passport under |
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another program: |
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(1) the person, if the person is an adult or a child |
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who has had the disabilities of minority removed; or |
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(2) the person's parent, legal guardian, or other |
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caretaker, if the person is a child. |
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(g) The commission shall coordinate the health passports |
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and procedures adopted for the Medicaid program under this section |
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with the health passport and procedures adopted under Section |
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266.006, Family Code, for a child in the foster care system to |
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ensure that a child's health passport is transferable between the |
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Medicaid program and that system. |
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SECTION 3. Section 32.102(b), Human Resources Code, as |
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added by Chapter 268 (S.B. 10), Acts of the 80th Legislature, |
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Regular Session, 2007, is amended to read as follows: |
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(b) If the executive commissioner determines that a need |
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exists for the use of health information technology in the medical |
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assistance program and that the technology is cost-effective, the |
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Health and Human Services Commission may, for the purposes |
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prescribed by Subsection (a): |
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(1) acquire and implement the technology; or |
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(2) evaluate the feasibility of developing and, if |
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feasible, develop, the technology through the use or expansion of |
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other systems or technologies the commission uses for other |
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purposes, including: |
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(A) the technologies used in the pilot program |
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implemented under Section 531.1063, Government Code; and |
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(B) a [the] health passport developed under |
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Section 266.006, Family Code, or Section 531.096, Government Code, |
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for persons receiving medical assistance not provided a health |
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passport under either of those provisions. |
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SECTION 4. Not later than the 60th day after the effective |
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date of this Act, the Health and Human Services Commission shall |
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establish the procedures required under Section 531.02416, |
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Government Code, as added by this Act. |
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SECTION 5. Not later than December 1, 2010, the Health and |
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Human Services Commission shall: |
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(1) assess, in conjunction with health information |
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exchanges that exchange information under the procedures |
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established under Section 531.02416, Government Code, as added by |
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this Act, the benefits to the state, patients, and health care |
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providers of exchanging secure health information with local or |
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regional health information exchanges; |
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(2) include, as part of the assessment required by |
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Subdivision (1) of this section, a return on investment analysis |
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for the guidelines developed under Section 531.02416(c)(1), |
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Government Code, as added by this Act; and |
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(3) report the commission's findings to the standing |
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committees of the senate and house of representatives having |
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primary jurisdiction over health and human services issues. |
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SECTION 6. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 7. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2009. |