81R10148 ALB-F
By: Davis of Harris H.B. No. 3235
A BILL TO BE ENTITLED
AN ACT
relating to the exchange of secure electronic health information
between the Health and Human Services Commission and local or
regional health information exchanges and the development of a
health passport for Medicaid recipients.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter B, Chapter 531, Government Code, is
amended by adding Section 531.02416 to read as follows:
Sec. 531.02416. ELECTRONIC HEALTH INFORMATION EXCHANGE
PROCEDURES. (a) The commission shall establish procedures for the
exchange of secure electronic health information between the
commission and local or regional health information exchanges.
(b) A local or regional health information exchange that
exchanges electronic health information under this section must
possess a functioning health information exchange database that
exchanges secure electronic health information among hospitals,
clinics, physicians' offices, and other health care providers that
are not each owned by a single entity or included in a single
operational unit or network. The information exchanged by the
local or regional health information exchange must include health
information for patients receiving services from state and federal
health and human services programs administered by the commission.
(c) In developing procedures under this section, the
commission shall:
(1) establish specific written guidelines, in
conjunction with interested health information exchanges,
specifying which health care providers will use which data elements
obtained from the commission and for what purposes, including
purposes related to reducing costs, improving access, and improving
quality of care for patients; and
(2) ensure compliance with all state and federal laws
and rules related to the transmission of health information,
including state privacy laws and the Health Insurance Portability
and Accountability Act of 1996 (42 U.S.C. Section 1320d et seq.) and
rules adopted under that Act.
(d) The procedures under this section must at a minimum
address the exchange of a patient's medication history. The
procedures may also address the exchange of additional health care
information.
SECTION 2. Subchapter B, Chapter 531, Government Code, is
amended by adding Section 531.096 to read as follows:
Sec. 531.096. HEALTH PASSPORT. (a) The commission, with
the assistance of physicians and other health care providers
experienced with the use of electronic health records, shall
develop and provide a health passport for each person who:
(1) is receiving medical assistance under the state
Medicaid program through a managed care plan, as defined by Section
533.001; and
(2) is not provided a health passport under another
law of this state.
(a-1) Notwithstanding Subsection (a), the commission is not
required to provide a health passport for each person described by
that subsection until September 1, 2014. Beginning as soon as
feasible after September 1, 2009, the commission shall provide a
health passport to each child entitled to a health passport under
Subsection (a), or if initial provision of health passports to all
children is impossible, to selected categories of children.
Thereafter, at intervals occurring as soon as possible, the
commission shall expand the provision of health passports to
additional children and finally to adults. This subsection expires
September 1, 2014.
(b) Information that is accessible through the health
passport provided under this section must be maintained in an
electronic format that uses the commission's existing computer
resources to the greatest extent possible.
(c) The executive commissioner shall adopt rules specifying
the information required to be included in the health passport. The
required information may include:
(1) the name and address of each of the person's
physicians and health care providers;
(2) a record of each visit to a physician or other
health care provider, including routine checkups;
(3) an immunization record;
(4) a list of the person's known health problems and
allergies;
(5) information on all medications prescribed to the
person in adequate detail to permit refills of prescriptions,
including the disease or condition that each medication treats; and
(6) any other available health history that physicians
and other health care providers who provide care for the person
determine is important.
(d) The system used to access the health passport must be
secure and maintain the confidentiality of the person's health
records. To the extent that this section authorizes the use or
disclosure of protected health information by a covered entity, as
those terms are defined by the privacy rule of the Administrative
Simplification subtitle of the Health Insurance Portability and
Accountability Act of 1996 (Pub. L. No. 104-191) contained in 45
C.F.R. Part 160 and 45 C.F.R. Part 164, Subparts A and E, the
covered entity shall ensure that the use or disclosure complies
with all applicable requirements, standards, or implementation
specifications of the privacy rule.
(e) The commission shall provide training or instructional
materials regarding use of a health passport to adults who receive
health passports, parents, guardians, and caretakers of children
who receive health passports, physicians, and other health care
providers.
(f) The commission shall make health passport information
available in printed and electronic formats to the following
individuals when a person loses eligibility for Medicaid, unless
the commission is required to provide a health passport under
another program:
(1) the person, if the person is an adult or a child
who has had the disabilities of minority removed; or
(2) the person's parent, legal guardian, or other
caretaker, if the person is a child.
(g) The commission shall coordinate the health passports
and procedures adopted for the Medicaid program under this section
with the health passport and procedures adopted under Section
266.006, Family Code, for a child in the foster care system to
ensure that a child's health passport is transferable between the
Medicaid program and that system.
SECTION 3. Section 32.102(b), Human Resources Code, as
added by Chapter 268 (S.B. 10), Acts of the 80th Legislature,
Regular Session, 2007, is amended to read as follows:
(b) If the executive commissioner determines that a need
exists for the use of health information technology in the medical
assistance program and that the technology is cost-effective, the
Health and Human Services Commission may, for the purposes
prescribed by Subsection (a):
(1) acquire and implement the technology; or
(2) evaluate the feasibility of developing and, if
feasible, develop, the technology through the use or expansion of
other systems or technologies the commission uses for other
purposes, including:
(A) the technologies used in the pilot program
implemented under Section 531.1063, Government Code; and
(B) a [the] health passport developed under
Section 266.006, Family Code, or Section 531.096, Government Code,
for persons receiving medical assistance not provided a health
passport under either of those provisions.
SECTION 4. Not later than the 60th day after the effective
date of this Act, the Health and Human Services Commission shall
establish the procedures required under Section 531.02416,
Government Code, as added by this Act.
SECTION 5. Not later than December 1, 2010, the Health and
Human Services Commission shall:
(1) assess, in conjunction with health information
exchanges that exchange information under the procedures
established under Section 531.02416, Government Code, as added by
this Act, the benefits to the state, patients, and health care
providers of exchanging secure health information with local or
regional health information exchanges;
(2) include, as part of the assessment required by
Subdivision (1) of this section, a return on investment analysis
for the guidelines developed under Section 531.02416(c)(1),
Government Code, as added by this Act; and
(3) report the commission's findings to the standing
committees of the senate and house of representatives having
primary jurisdiction over health and human services issues.
SECTION 6. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 7. 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.