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AN ACT
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relating to the exchange of health information in this state; |
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creating a criminal offense. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Title 4, Civil Practice and Remedies Code, is |
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amended by adding Chapter 74A to read as follows: |
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CHAPTER 74A. LIMITATION OF LIABILITY RELATING TO HEALTH |
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INFORMATION EXCHANGES |
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Sec. 74A.001. DEFINITIONS. In this chapter: |
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(1) "Gross negligence" has the meaning assigned by |
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Section 41.001. |
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(2) "Health care provider" means any individual, |
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partnership, professional association, corporation, facility, or |
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institution duly licensed, certified, registered, or chartered by |
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this state to provide health care or medical care, including a |
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physician. The term includes: |
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(A) an officer, director, shareholder, member, |
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partner, manager, owner, or affiliate of a physician or other |
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health care provider; and |
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(B) an employee, independent contractor, or |
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agent of a physician or other health care provider acting in the |
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course and scope of the employment or contractual relationship. |
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(3) "Health information exchange" has the meaning |
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assigned by Section 182.151, Health and Safety Code. The term |
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includes: |
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(A) an officer, director, shareholder, member, |
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partner, manager, owner, or affiliate of the health information |
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exchange; and |
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(B) an employee, independent contractor, or |
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agent of the health information exchange acting in the course and |
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scope of the employment or contractual relationship. |
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(4) "Malice" has the meaning assigned by Section |
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41.001. |
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(5) "Physician" means: |
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(A) an individual licensed to practice medicine |
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in this state under Subtitle B, Title 3, Occupations Code; |
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(B) a professional association organized by an |
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individual physician or a group of physicians; |
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(C) a partnership or limited liability |
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partnership formed by a group of physicians; |
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(D) a limited liability company formed by a group |
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of physicians; |
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(E) a nonprofit health corporation certified by |
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the Texas Medical Board under Chapter 162, Occupations Code; or |
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(F) a single legal entity authorized to practice |
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medicine in this state owned by a group of physicians. |
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Sec. 74A.002. LIMITATION ON LIABILITY OF HEALTH CARE |
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PROVIDERS RELATING TO HEALTH INFORMATION EXCHANGES. (a) Unless the |
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health care provider acts with malice or gross negligence, a health |
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care provider who provides patient information to a health |
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information exchange is not liable for any damages, penalties, or |
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other relief related to the obtainment, use, or disclosure of that |
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information in violation of federal or state privacy laws by a |
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health information exchange, another health care provider, or any |
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other person. |
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(b) Nothing in this section may be construed to create a |
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cause of action or to create a standard of care, obligation, or duty |
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that forms the basis for a cause of action. |
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Sec. 74A.003. APPLICABILITY OF OTHER LAW. The protections, |
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immunities, and limitations of liability provided by this chapter |
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are in addition to any other protections, immunities, and |
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limitations of liability provided by other law. |
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SECTION 2. Section 531.0162, Government Code, is amended by |
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adding Subsections (e), (f), (g), and (h) to read as follows: |
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(e) The executive commissioner shall ensure that: |
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(1) all information systems available for use by the |
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commission or a health and human services agency in sending |
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protected health information to a health care provider or receiving |
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protected health information from a health care provider, and for |
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which planning or procurement begins on or after September 1, 2015, |
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are capable of sending or receiving that information in accordance |
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with the applicable data exchange standards developed by the |
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appropriate standards development organization accredited by the |
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American National Standards Institute; |
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(2) if national data exchange standards do not exist |
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for a system described by Subdivision (1), the commission makes |
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every effort to ensure the system is interoperable with the |
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national standards for electronic health record systems; and |
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(3) the commission and each health and human services |
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agency establish an interoperability standards plan for all |
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information systems that exchange protected health information |
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with health care providers. |
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(f) Not later than December 1 of each even-numbered year, |
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the executive commissioner shall report to the governor and the |
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Legislative Budget Board on the commission's and the health and |
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human services agencies' measurable progress in ensuring that the |
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information systems described in Subsection (e) are interoperable |
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with one another and meet the appropriate standards specified by |
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that subsection. The report must include an assessment of the |
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progress made in achieving commission goals related to the exchange |
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of health information, including facilitating care coordination |
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among the agencies, ensuring quality improvement, and realizing |
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cost savings. |
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(g) The executive commissioner by rule may develop and the |
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commission may implement a system to reimburse providers of health |
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care services under the state Medicaid program for review and |
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transmission of electronic health information if feasible and |
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cost-effective. |
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(h) In this section, "health care provider" and "provider of |
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health care services" include a physician. |
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SECTION 3. Section 531.02176, Government Code, as amended |
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by S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, is |
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amended to read as follows: |
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Sec. 531.02176. EXPIRATION OF MEDICAID REIMBURSEMENT FOR |
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PROVISION OF HOME TELEMONITORING SERVICES. Notwithstanding any |
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other law, the commission may not reimburse providers under |
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Medicaid for the provision of home telemonitoring services on or |
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after September 1, 2019 [2015]. |
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SECTION 4. Section 81.044(a), Health and Safety Code, as |
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amended by S.B. 219, Acts of the 84th Legislature, Regular Session, |
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2015, is amended to read as follows: |
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(a) The executive commissioner shall prescribe the form and |
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method of reporting under this chapter, which may be in writing, by |
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telephone, by electronic data transmission, through a health |
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information exchange as defined by Section 182.151 if requested and |
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authorized by the person required to report, or by other means. |
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SECTION 5. Section 82.008(a), Health and Safety Code, as |
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amended by S.B. 219, Acts of the 84th Legislature, Regular Session, |
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2015, is amended to read as follows: |
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(a) To ensure an accurate and continuing source of data |
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concerning cancer, each health care facility, clinical laboratory, |
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and health care practitioner shall furnish to the department, on |
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request, data the executive commissioner considers necessary and |
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appropriate that is derived from each medical record pertaining to |
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a case of cancer that is in the custody or under the control of the |
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health care facility, clinical laboratory, or health care |
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practitioner. The department may not request data that is more than |
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three years old unless the department is investigating a possible |
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cancer cluster. At the request and with the authorization of the |
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applicable health care facility, clinical laboratory, or health |
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care practitioner, data may be furnished to the department through |
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a health information exchange as defined by Section 182.151. |
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SECTION 6. Section 161.007(d), Health and Safety Code, is |
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amended to read as follows: |
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(d) A health care provider who administers an immunization |
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to an individual younger than 18 years of age shall provide data |
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elements regarding an immunization to the department. A health |
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care provider who administers an immunization to an individual 18 |
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years of age or older may submit data elements regarding an |
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immunization to the department. At the request and with the |
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authorization of the health care provider, the data elements may be |
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submitted through a health information exchange as defined by |
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Section 182.151. The data elements shall be submitted in a format |
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prescribed by the department. The department shall verify consent |
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before including the information in the immunization registry. The |
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department may not retain individually identifiable information |
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about an individual for whom consent cannot be verified. |
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SECTION 7. Section 161.00705(a), Health and Safety Code, is |
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amended to read as follows: |
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(a) The department shall maintain a registry of persons who |
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receive an immunization, antiviral, and other medication |
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administered to prepare for a potential disaster, public health |
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emergency, terrorist attack, hostile military or paramilitary |
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action, or extraordinary law enforcement emergency or in response |
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to a declared disaster, public health emergency, terrorist attack, |
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hostile military or paramilitary action, or extraordinary law |
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enforcement emergency. A health care provider who administers an |
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immunization, antiviral, or other medication shall provide the data |
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elements to the department. At the request and with the |
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authorization of the health care provider, the data elements may be |
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provided through a health information exchange as defined by |
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Section 182.151. |
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SECTION 8. Section 161.00706(b), Health and Safety Code, is |
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amended to read as follows: |
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(b) A health care provider, on receipt of a request under |
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Subsection (a)(1), shall submit the data elements to the department |
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in a format prescribed by the department. At the request and with |
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the authorization of the health care provider, the data elements |
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may be submitted through a health information exchange as defined |
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by Section 182.151. The department shall verify the person's |
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request before including the information in the immunization |
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registry. |
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SECTION 9. Section 161.0073(c), Health and Safety Code, is |
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amended to read as follows: |
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(c) A person required to report information to the |
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department for registry purposes or authorized to receive |
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information from the registry may not disclose the individually |
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identifiable information of an individual to any other person |
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without the written or electronic consent of the individual or the |
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individual's legally authorized representative, except as provided |
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by Sections 161.007, 161.00705, 161.00706, and 161.008 of this |
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code, Chapter 159, Occupations Code, or Section 602.053, Insurance |
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Code. |
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SECTION 10. Section 161.008, Health and Safety Code, is |
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amended by adding Subsection (i) to read as follows: |
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(i) At the request and with the authorization of the |
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applicable health care provider, immunization history or data may |
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be submitted to or obtained by the department through a health |
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information exchange as defined by Section 182.151. |
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SECTION 11. Chapter 182, Health and Safety Code, is amended |
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by adding Subchapter D to read as follows: |
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SUBCHAPTER D. HEALTH INFORMATION EXCHANGES |
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Sec. 182.151. DEFINITION. In this subchapter, "health |
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information exchange" means an organization that: |
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(1) assists in the transmission or receipt of |
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health-related information among organizations transmitting or |
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receiving the information according to nationally recognized |
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standards and under an express written agreement with the |
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organizations; |
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(2) as a primary business function, compiles or |
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organizes health-related information designed to be securely |
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transmitted by the organization among physicians, other health care |
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providers, or entities within a region, state, community, or |
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hospital system; or |
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(3) assists in the transmission or receipt of |
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electronic health-related information among physicians, other |
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health care providers, or entities within: |
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(A) a hospital system; |
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(B) a physician organization; |
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(C) a health care collaborative, as defined by |
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Section 848.001, Insurance Code; |
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(D) an accountable care organization |
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participating in the Pioneer Model under the initiative by the |
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Innovation Center of the Centers for Medicare and Medicaid |
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Services; or |
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(E) an accountable care organization |
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participating in the Medicare Shared Savings Program under 42 |
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U.S.C. Section 1395jjj. |
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Sec. 182.152. AUTHORITY OF HEALTH INFORMATION EXCHANGE. |
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(a) Notwithstanding Sections 81.046, 82.009, 161.0073, and |
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161.008, a health information exchange may access and transmit |
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health-related information under Sections 81.044(a), 82.008(a), |
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161.007(d), 161.00705(a), 161.00706(b), and 161.008(i) if the |
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access or transmittal is: |
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(1) made for the purpose of assisting in the reporting |
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of health-related information to the appropriate agency; |
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(2) requested and authorized by the appropriate health |
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care provider, practitioner, physician, facility, clinical |
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laboratory, or other person who is required to report |
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health-related information; |
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(3) made in accordance with the applicable consent |
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requirements for the immunization registry under Subchapter A, |
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Chapter 161, if the information being accessed or transmitted |
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relates to the immunization registry; and |
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(4) made in accordance with the requirements of this |
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subchapter and all other state and federal law. |
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(b) A health information exchange may only use and disclose |
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the information that it accesses or transmits under Subsection (a) |
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in compliance with this subchapter and all applicable state and |
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federal law, and may not exchange, sell, trade, or otherwise make |
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any prohibited use or disclosure of the information. |
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Sec. 182.153. COMPLIANCE WITH LAW; SECURITY. A health |
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information exchange that collects, transmits, disseminates, |
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accesses, or reports health-related information under this |
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subchapter shall comply with all applicable state and federal law, |
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including secure electronic data submission requirements. |
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Sec. 182.154. CRIMINAL PENALTY. (a) A person who collects, |
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transmits, disseminates, accesses, or reports information under |
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this subchapter on behalf of or as a health information exchange |
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commits an offense if the person, with the intent to violate this |
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subchapter, allows health-related information in the possession of |
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a health information exchange to be used or disclosed in a manner |
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that violates this subchapter. |
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(b) An offense under this section is a Class A misdemeanor. |
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Sec. 182.155. IMMUNITIES AND DEFENSES CONTINUED. |
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Collecting, transmitting, disseminating, accessing, or reporting |
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information through a health information exchange does not alone |
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deprive a physician or health care provider of an otherwise |
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applicable immunity or defense. |
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SECTION 12. Chapter 74A, Civil Practice and Remedies Code, |
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as added by this Act, applies only to a cause of action that accrues |
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on or after the effective date of this Act. A cause of action that |
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accrues before the effective date of this Act is governed by the law |
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in effect immediately before the effective date of this Act, and |
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that law is continued in effect for that purpose. |
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SECTION 13. This Act takes effect September 1, 2015. |
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______________________________ |
______________________________ |
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President of the Senate |
Speaker of the House |
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I certify that H.B. No. 2641 was passed by the House on May |
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15, 2015, by the following vote: Yeas 120, Nays 5, 2 present, not |
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voting; that the House refused to concur in Senate amendments to |
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H.B. No. 2641 on May 27, 2015, and requested the appointment of a |
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conference committee to consider the differences between the two |
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houses; and that the House adopted the conference committee report |
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on H.B. No. 2641 on May 31, 2015, by the following vote: Yeas 127, |
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Nays 17, 2 present, not voting. |
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______________________________ |
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Chief Clerk of the House |
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I certify that H.B. No. 2641 was passed by the Senate, with |
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amendments, on May 25, 2015, by the following vote: Yeas 30, Nays |
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1; at the request of the House, the Senate appointed a conference |
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committee to consider the differences between the two houses; and |
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that the Senate adopted the conference committee report on H.B. No. |
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2641 on May 30, 2015, by the following vote: Yeas 31, Nays 0. |
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______________________________ |
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Secretary of the Senate |
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APPROVED: __________________ |
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Date |
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__________________ |
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Governor |