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.