81R9755 SJM-D
 
  By: Zerwas H.B. No. 4571
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to a statewide electronic health records bank.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subtitle I, Title 2, Health and Safety Code, is
  amended by adding Chapter 183 to read as follows:
  CHAPTER 183. HEALTH RECORDS BOARD
         Sec. 183.001.  DEFINITIONS.  In this chapter:
               (1)  "Bank" means the statewide electronic health
  records bank created under this chapter.
               (2)  "Board" means the Health Records Board created
  under this chapter.
               (3)  "Department" means the Department of State Health
  Services.
               (4)  "Electronic health record" means the medical
  record of an individual that is stored in an electronic format.
               (5)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (6)  "Health care provider" means an individual or
  facility licensed, certified, or otherwise authorized to
  administer health care, for profit or otherwise, in the ordinary
  course of business or professional practice and includes a
  physician.
               (7)  "Medical home" means a primary care physician who
  provides preventive and primary care to a patient on an ongoing
  basis and coordinates with specialists when health care services
  provided by a specialist are needed.
         Sec. 183.002.  COMPOSITION OF BOARD; PRESIDING OFFICER.  (a)  
  The department shall create a Health Records Board. The board is
  composed of seven members as follows:
               (1)  the executive director of the Health and Human
  Services Commission or the executive director's designee;
               (2)  a representative from the board of directors of
  the Texas Health Services Authority or the board's designee; and
               (3)  the following representatives appointed by the
  governor:
                     (A)  a representative from a licensed hospital;
                     (B)  a representative from an appropriate
  physician's organization;
                     (C)  a representative from a health insurer;
                     (D)  a representative from a consumer advisory
  organization with a background in health care information
  technology; and
                     (E)  a representative from an appropriate
  academic or research institution.
         (b)  The governor shall appoint a member of the board to
  serve as the presiding officer of the board.
         Sec. 183.003.  DEPARTMENT DUTIES. The department shall
  provide staff and resources as necessary for the operation of the
  board.
         Sec. 183.004.  TERMS; VACANCY. (a)  Members of the board
  appointed by the governor serve two-year terms expiring February 1
  of each odd-numbered year.
         (b)  A member may be reappointed.
         (c)  A vacancy on the board shall be filled for the remainder
  of the unexpired term in the same manner as provided by Section
  183.002.
         Sec. 183.005.  COMPENSATION; REIMBURSEMENT. (a)  A member
  of the board may not receive compensation for service on the board.
         (b)  A member may be reimbursed for the member's actual and
  necessary expenses for meals, lodging, transportation, and
  incidental expenses incurred while performing board business,
  subject to any applicable limitation on reimbursement prescribed by
  the General Appropriations Act.
         Sec. 183.006.  BOARD POWERS AND DUTIES; PLAN OF OPERATION.
  (a)  The board shall develop a plan of operation to:
               (1)  enable a seamless electronic health
  infrastructure to support the health care system in this state;
               (2)  improve consumer safety and quality of care
  through an electronic health infrastructure to encourage the
  utilization of a medical home; and
               (3)  promote, implement, and facilitate the
  implementation of the bank to enable the secure exchange of health
  information between health care providers and allow a consumer to
  access electronic records of all health services and information
  prescribed and collected on the consumer during the consumer's
  lifetime.
         (b)  In accordance with the plan of operation, the board
  shall implement and administer a bank that:
               (1)  is web-based;
               (2)  is accessible through a card issued to consumers
  capable of:
                     (A)  electronically verifying eligibility for
  medical services in real time;
                     (B)  effectuating automatic check-in of a
  consumer at a health care facility;
                     (C)  maintaining real-time electronic payment
  information, by health care provider, for services provided to the
  consumer; and
                     (D)  accessing a consumer's electronic health
  record for the health care provider to assist in the care of the
  consumer;
               (3)  allows health care providers and public and
  private consumers and patients to share health information through
  electronic means;
               (4)  complies with state and federal privacy
  requirements, including the federal Health Insurance Portability
  and Accountability Act (HIPAA);
               (5)  is operated through a secure means that protects
  the privacy of a consumer;
               (6)  is capable of interoperability with existing
  health records databases of other states or the federal government
  to enable the consolidation of all health care information
  collected on a consumer during the course of the consumer's
  lifetime, regardless of the collector;
               (7)  enables a consumer to electronically communicate
  with the consumer's medical home regarding appointment requests,
  prescription refill requests, e-mail communications, and receipt
  of condition education content from a health care provider; and
               (8)  enhances health care quality, consumer safety,
  communication of consumer information, chronic condition
  management capabilities, consumer and provider satisfaction,
  clinical and administrative cost-effectiveness, and public health
  emergency preparedness.
         Sec. 183.007.  PLAN OF OPERATION; AMENDMENTS; APPROVAL. (a)  
  The board shall submit to the executive commissioner a plan of
  operation for the implementation of the bank that complies with the
  requirements of Section 183.006(b).  The board may submit
  amendments to the plan of operation to the executive commissioner.
         (b)  The executive commissioner shall review the plan of
  operation, or any amendments to the plan submitted by the board, and
  approve the plan or amended plan if the plan or amended plan is
  feasible.
         (c)  The board may not implement the plan of operation, or
  any amendment to the plan, until the executive commissioner
  approves the plan or amendment, as applicable.
         (d)  The executive commissioner shall approve or deny a plan
  of operation or amendments to the plan not later than the 30th day
  after the date the board submits the plan or amendments.  For good
  cause shown, the executive commissioner may extend the time to act
  under this subsection.
         Sec. 183.008.  IMPLEMENTATION OF BANK. Not later than the
  first anniversary of the date the executive commissioner approves a
  plan of operation under Section 183.007, the board shall implement
  the bank according to the plan of operation approved by the
  executive commissioner.
         Sec. 183.009.  ENROLLMENT IN BANK. An individual may create
  a record in the bank by:
               (1)  completing enrollment and consent forms
  prescribed by the board when checking in to a health care facility;
  or
               (2)  contacting the board directly and providing
  necessary information.
         Sec. 183.010.  CONSUMER ACCESS TO RECORDS. (a)  A consumer
  owns an entire electronic health record created by the consumer in
  the bank, and a consumer shall have access to the consumer's record
  at any time.
         (b)  A consumer may add personal health information to the
  consumer's electronic health record at any time after creating the
  record.
         (c)  A consumer may not alter information contained in the
  consumer's electronic health record unless an alteration is
  approved in the manner specified by the plan of operation. The bank
  shall identify an addition or alteration made by a consumer to the
  consumer's record to the consumer.
         (d)  A health care provider may access a consumer's
  electronic health record if the consumer or the consumer's legal
  representative consents to the access.
         Sec. 183.011.  CONSUMER PRIVACY. (a)  The board may not
  release health information contained in the bank to any person
  without the consent of the consumer, except that the board may
  without the consumer's consent release information to:
               (1)  the consumer's health insurer or health benefit
  plan;
               (2)  the consumer's employer; or
               (3)  a state employee for the purposes of:
                     (A)  oversight of a state health program,
  including a disease management program;
                     (B)  tracking infectious diseases in this state;
                     (C)  state wellness initiatives and programs; or
                     (D)  research of state medical trends.
         (b)  A health care provider may not be required to redact
  information disclosed under this section.
         Sec. 183.012.  RULES. The board shall adopt rules necessary
  for the administration of the bank.
         SECTION 2.  (a) As soon as practicable after the effective
  date of this Act, the Department of State Health Services shall
  establish the Health Records Board under Section 183.002, Health
  and Safety Code, as added by this Act, and the relevant appointing
  authorities shall appoint the members of the board under that
  section.
         (b)  Not later than March 1, 2010, the Health Records Board
  created under Chapter 183, Health and Safety Code, as added by this
  Act, shall adopt the rules required by that chapter.
         (c)  Not later than September 1, 2010, the Health Records
  Board shall submit the initial plan of operation for the statewide
  electronic health records bank, as required by Chapter 183, Health
  and Safety Code, as added by this Act.
         SECTION 3.  This Act takes effect immediately if it receives
  a vote of two-thirds of all the members elected to each house, as
  provided by Section 39, Article III, Texas Constitution.  If this
  Act does not receive the vote necessary for immediate effect, this
  Act takes effect September 1, 2009.