HBA-MPM H.B. 1513 76(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 1513
By: Maxey
Public Health
3/23/1999
Introduced



BACKGROUND AND PURPOSE 

The Texas Health Care Information Council (council) was created by the 73rd
Texas Legislature to develop a statewide health care data collection system
to collect health care charges, utilization data, provider quality data,
and outcome data to facilitate the promotion and accessibility of
cost-effective, quality health care.  By collecting hospital-based data and
requiring HMO reporting, the council has been able to provide useful report
cards on HMOs. 

H.B. 1513 provides a new definition for "public use data" to include
patient level data that has had patient identifying information removed and
that identifies physicians only by use of uniform physician identifiers,
rather than identifying both physicians and patients by their respective
identifiers.  Furthermore, it makes changes to the compositions of the
council's technical advisory committees, deletes specific data from the
data the council is prohibited to release and to which a person or entity
may not gain access unless authorized.  This bill also authorizes the
Health and Human Services Commission to charge a provider or a health
benefit plan a fee for any incorrect data submitted; excludes provider
quality data relating to rural providers from the list of those providers
about whom the council is required to release data.  It  requires the
council to establish a committee which has experience in ethics, patient
confidentiality, and health care data to approve requests for information
and to adopt rules regarding the release of data. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that rulemaking
authority is expressly delegated to the Texas Health Care Information
Council in SECTION 8 (Section 108.0135) of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 108.002(14), Health and Safety Code, to redefine
"public use data" to include patient level data that has had patient
identifying information removed and that identifies physicians only by use
of uniform physician identifiers, rather than identifying both physicians
and patients by their respective identifiers. 

SECTION 2.  Amends Section 108.003(g), Health and Safety Code, to provide
that Chapter 2110 (State Agency Advisory Committees), Government Code, does
not apply to the four technical advisory committees (committees) appointed
by the Texas Health Care Information Council (council) as described in this
subsection.  Deletes the requirement that two of the committees include at
least five practicing physicians licensed in this state, and deletes the
development and dissemination of consumer education information and
materials from the advice and recommendations which the first of these
committees provides to the council.  Deletes a third committee that is
composed of individuals who have expertise in the reimbursement of medical
education and research costs. Redesignates Subdivisions (4) and (5) to
Subdivisions (3) and (4), respectively.  Makes conforming and
nonsubstantive changes. 

SECTION 3.  Amends Section 108.0045, Health and Safety Code, to prohibit
the council from producing public information for inspection or duplication
before the 20th business day after the information is requested.  Requires
the council to verify the accuracy of the public information before
producing it.  

 SECTION 4.  Amends Section 108.009, Health and Safety Code, by adding
Subsection (j), as follows: 

(j)  Authorizes the Health and Human Services Commission to charge a
provider or a health benefit plan a fee for any incorrect data that either
entity submits and requires these fees to be placed in the general revenue
fund to the credit of the health care information account. Provides that
money in this account may be appropriated only to the council to enforce
this chapter. 

SECTION 5.  Amends Section 108.010(i), Health and Safety Code, to exclude
provider quality data relating to rural providers from the list of those
providers about whom the council is required to release data because the
rural providers do not meet the requirements of Section 108.0025(2),
Health and Safety Code, which specifies that a provider is a rural provider
if it is not a state-owned hospital or one managed or owned by an
individual, association, partnership, corporation, or other legal entity
that owns or manages one or more hospitals).  Specifies that the data
released shall be in an aggregate form without uniform physician
identifiers, rather than without patient and physician identifiers. 

SECTION 6.  Amends Section 108.011(i), Health and Safety Code, to make
conforming changes. 

SECTION 7.  Amends Sections 108.013(c), (e), (f), (g), and (h), Health and
Safety Code, to delete data that could be reasonably expected to reveal the
zip code of a patient's primary residence from that data the council is
prohibited to release, and to which a person or entity may not gain access
unless authorized by this chapter.  Removes the provision which expressly
exempted the release of a uniform patient identifier from possible
prohibition in Subsections (c) and (g).  Makes conforming and
nonsubstantive changes. 

SECTION 8.  Amends Chapter 108, Health and Safety Code, by adding Section
108.0135, as follows: 

Sec. 108.0135.  RELEASE OF INFORMATION.  (a)  Requires the council to
establish a committee which has experience in ethics, patient
confidentiality, and health care data to approve requests for information.
Requires the council to adopt rules similar to the federal Health Care
Financing Administration's guidelines on releasing data to help the
committee determine whether to approve a request for information.  Provides
that a request for information must be made on a form created by the
council. 

SECTION 9.  Amends Section 108.014, Health and Safety Code, by amending
Subsection (c) and adding Subsection (d), as follows: 

(c)  Provides that the venue of an action brought under this section is in
Travis County. 

(d) Requires a civil penalty recovered in a suit instituted by the attorney
general under this chapter to be deposited in the general revenue fund to
the credit of the health care information account. 

SECTION 10.  Amends Chapter 108, Health and Safety Code, by adding Section
108.0142, as follows: 

Sec. 108.0142. RELEASE OF LIABILITY.  Provides that notwithstanding any
other law, a provider or health benefit plan that submits data to the
council under this chapter is not liable to the extent that the release of
information violates the law. 

SECTION 11.  Effective date: September 1, 1999.

SECTION 12.  Emergency clause.