HBA-MPM, NMO H.B. 2171 76(R)BILL ANALYSIS


Office of House Bill AnalysisH.B. 2171
By: Luna, Vilma
Public Health
7/19/1999
Enrolled


BACKGROUND AND PURPOSE 

Prior to the 76th Legislature, state law authorized certain health care
entities to form a medical peer review committee or a medical committee to
evaluate the medical or health-care services provided by each respective
entity.  However, the law did not grant this same authority to a hospital
district that had contracted out its medical or health care services.   

In 1996, the Nueces County Hospital District leased its hospital and three
clinics to Spohn Health System, a local Catholic healthcare system.  The
hospital district separately contracted with the Spohn System to furnish
medical aid and hospital care to indigent and needy persons within the
hospital district's boundaries.  As a result of the hospital district
leasing its hospital, the law no longer authorized it to evaluate medical
and heath-care services through a medical peer review committee or a
medical committee.   

H.B. 2171 authorizes the governing body of a hospital, medical
organization, university medical school or health science center, health
maintenance organization, extended care facility, hospital district, or
hospital authority to form a medical peer review committee or a medical
committee to evaluate medical and health-care services provided or paid for
by the entity. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that this bill does
not expressly delegate any additional rulemaking authority to a state
officer, department, agency, or institution. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 1.03(a)(5), Article 4495b, V.T.C.S. (Medical
Practice Act), to include in the definition of "health care entity"certain
entities that pay for, in addition to provide, medical or health-care
services and that follow a formal peer review process.  Adds a hospital
district and a hospital authority to that list of entities.  Makes
conforming changes relating to codification. 

SECTION 2.  Amends Section 5.06, Article 4495b, V.T.C.S. (Medical Practice
Act), by adding Subsection (v), as follows: 

(v) Provides that this section (Reporting and Confidentiality Requirements)
does not impose liability or waive immunity for a hospital district or
hospital authority that has common-law, statutory, or other immunity. 

SECTION 3.  Amends Section 161.031(a), Health and Safety Code, to include
in the definition of "medical committee" a committee, including a joint
committee, of a hospital district or hospital authority. 

SECTION 4.  Amends Sections 161.032(a) and (c), Health and Safety Code, to
provide that a proceeding of a medical peer review committee, as defined by
Section 1.03 (Definitions), Article 4495b, V.T.C.S. (Medical Practice Act),
or medical committee, or a meeting of the governing body of a public
hospital, hospital district, or hospital authority at which the governing
body receives records, information, or reports provided by a medical
committee or medical peer review committee is not subject to Chapter 551
(Open Meetings), Government Code.  Makes the following not subject to
disclosure under Chapter 552 (Public Information), Government Code:
records, information, or  reports of a medical committee or medical peer
review committee, and records, information, or reports provided by a
medical committee or medical peer review committee to the governing body of
a public hospital, hospital district, or hospital authority.  Adds a
hospital district and a hospital authority to the list of entities to whose
records maintained in the regular course of business this section (Records
and Proceedings Confidential) and Section 5.06 (Reporting and
Confidentiality Requirements), Article 4495b, V.T.C.S. (Medical Practice
Act), do not apply. 

SECTION 5.  Amends the heading of Subchapter D, Chapter 161, Health and
Safety Code, as follows: 

SUBCHAPTER D.  New heading: MEDICAL COMMITTEES AND MEDICAL
PEER REVIEW COMMITTEES

Deletes "Records of and Immunities for" and adds "and Medical Peer Review
Committees" to the heading. 

SECTION 6.  Amends Subchapter D, Chapter 161, Health and Safety Code, by
adding Section 161.0315, as follows: 

Sec.  161.0315.  AUTHORITY OF GOVERNING BODY TO FORM COMMITTEE TO EVALUATE
MEDICAL AND HEALTH-CARE SERVICES.  (a) Authorizes the governing body of a
hospital, medical organization, university medical school or health science
center, health maintenance organization, extended care facility, hospital
district, or hospital authority to form a medical peer review committee or
a medical committee to evaluate medical and health care services, except as
provided by this section. 

(b)  Prohibits a medical peer review committee or medical committee formed
by the governing body of a hospital district from evaluating medical and
health care services provided by a health care facility that contracts with
the district to provide those services and has formed a medical peer review
committee or medical committee to evaluate the facility's services, except
as provided by Subsection (d). 

(c)  Authorizes a hospital district to require in a contract with a health
care facility described by Subsection (b) a provision allowing the
district's governing body to appoint a specified number of members to the
facility's medical peer review committee or medical committee to evaluate
medical and health care services for which the district contracts with the
facility to provide.  Authorizes the governing body of a hospital district
to review a report from a facility's medical peer review committee or
medical committee under this section in a closed meeting.  Provides that a
report, information, or record the district receives that is related to a
review action conducted under contract terms is subject to certain
confidentiality and disclosure requirements. 

(d) Provides that if a hospital district and health care facility described
by Subsection (b) do not agree on a contract provision described by
Subsection (c), the district has, with respect to a review action for the
evaluation of medical and health care services provided by the facility
under a contract with the district, a right to take certain actions with
respect to the review action. 

(e)  Authorizes the governing body of a hospital district to receive a
report under Subsection (d) in a closed meeting.  Provides that this
report, information, or a record the district receives under Subsection (d)
is subject to certain confidentiality and disclosure requirements. 

SECTION 7.Emergency clause.
  Effective date: upon passage.