S.B. No. 156
AN ACT
relating to health care data collected by the Department of State
Health Services and access to certain confidential patient
information within the department, including data and confidential
patient information concerning bleeding and clotting disorders,
and other issues related to bleeding and clotting disorders.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle E, Title 2, Health and Safety Code, is
amended by adding Chapter 103A to read as follows:
CHAPTER 103A. TEXAS BLEEDING DISORDERS ADVISORY COUNCIL
Sec. 103A.001. DEFINITIONS. In this chapter:
(1) "Commissioner" means the commissioner of state
health services.
(2) "Council" means the Texas Bleeding Disorders
Advisory Council.
(3) "Department" means the Department of State Health
Services.
(4) "Hemophilia" has the meaning assigned by Section
41.001.
Sec. 103A.002. COMPOSITION OF COUNCIL. (a) The council is
composed of:
(1) the commissioner and the commissioner of
insurance, or their designees, serving as nonvoting members; and
(2) 10 voting members jointly appointed by the
commissioner and the commissioner of insurance as follows:
(A) one member who is a physician licensed to
practice medicine in this state under Subtitle B, Title 3,
Occupations Code, who at the time of appointment treats individuals
with hemophilia or other bleeding or clotting disorders;
(B) one member who is a nurse licensed under
Chapter 301, Occupations Code, who at the time of appointment
treats individuals with hemophilia or other bleeding or clotting
disorders;
(C) one member who is a social worker licensed
under Chapter 505, Occupations Code, who at the time of appointment
treats individuals with hemophilia or other bleeding or clotting
disorders;
(D) one member who is a representative of a
hemophilia treatment center in this state that is federally funded;
(E) one member who is a representative of a
health insurer or other health benefit plan issuer that holds a
certificate of authority issued by the Texas Department of
Insurance;
(F) one member who is a representative of a
volunteer or nonprofit health organization that serves residents of
this state who have hemophilia or another bleeding or clotting
disorder;
(G) one member who has hemophilia or is a
caregiver of a person with hemophilia;
(H) one member who has a bleeding disorder other
than hemophilia or is a caregiver of a person with a bleeding
disorder other than hemophilia;
(I) one member who has a clotting disorder or is a
caregiver of a person with a clotting disorder; and
(J) one member who is a pharmacist licensed under
Subtitle J, Title 3, Occupations Code, with hemophilia therapy
experience, who at the time of appointment represents a pharmacy
provider that is not a specialty pharmacy provider participating in
the Drug Pricing Program under Section 340B, Public Health Service
Act (42 U.S.C. Section 256b).
(b) In addition to council members appointed under
Subsection (a), the commissioner and the commissioner of insurance
may jointly appoint up to five nonvoting members, including:
(1) persons with hemophilia or other bleeding or
clotting disorders or caregivers of persons with hemophilia or
other bleeding or clotting disorders; and
(2) persons experienced in the diagnosis, treatment,
care, and support of persons with hemophilia or other bleeding or
clotting disorders.
Sec. 103A.003. VACANCY. If a vacancy occurs on the council,
the commissioner and the commissioner of insurance shall jointly
appoint a person to serve for the remainder of the unexpired term.
Sec. 103A.004. PRESIDING OFFICER. Council members shall
elect from among the voting council members a presiding officer.
The presiding officer retains all voting rights.
Sec. 103A.005. COMPENSATION AND REIMBURSEMENT. A council
member may not:
(1) receive compensation for service on the council;
and
(2) be reimbursed for actual and necessary expenses
incurred while performing council business except to the extent
that money available under Section 103A.009 is designated for that
purpose.
Sec. 103A.006. MEETINGS. The council shall meet at least
quarterly and at the call of the commissioner or presiding officer.
Sec. 103A.007. DUTIES OF COUNCIL. The council using
existing resources may conduct studies and advise the department,
the Health and Human Services Commission, and the Texas Department
of Insurance on:
(1) public use data, outcome data, and other
information submitted to or collected by the department under
Chapter 108 or other law related to hemophilia or other bleeding or
clotting disorders and the department's disclosure and
dissemination of that information within and outside the
department; and
(2) other issues that affect the health and wellness
of persons living with hemophilia or other bleeding or clotting
disorders.
Sec. 103A.008. ANNUAL REPORTS BY COUNCIL AND COMMISSIONER.
(a) Not later than December 1 of each even-numbered year, the
council using existing resources shall submit a report of its
findings and recommendations to the governor, the lieutenant
governor, and the speaker of the house of representatives. The
council's report must be made public and is subject to public review
and comment before adoption by the council.
(b) Not later than six months after the date the council's
annual report is issued, the commissioner shall report on efforts
to implement the recommendations in the report. The commissioner's
annual report must:
(1) be made available to the public; and
(2) include any related state or national activities
in which the council participates.
Sec. 103A.009. GIFTS, GRANTS, AND DONATIONS. The
commissioner may accept for the council gifts, grants, and
donations to fulfill the council's purposes and duties under this
chapter. The department is not required to perform any
fund-raising activities or to solicit donations for the council.
Sec. 103A.010. CERTAIN FUNDING PROHIBITED. The council may
not accept any funds that are appropriated by the legislature for
the state fiscal biennium beginning September 1, 2011. This
section expires September 1, 2013.
Sec. 103A.011. EXPIRATION. This chapter expires and the
council is abolished September 1, 2015.
SECTION 2. Section 108.002, Health and Safety Code, is
amended by amending Subdivision (7) and adding Subdivision (8-a) to
read as follows:
(7) "Department" means the [Texas] Department of State
Health Services.
(8-a) "Executive commissioner" means the executive
commissioner of the Health and Human Services Commission.
SECTION 3. Chapter 108, Health and Safety Code, is amended
by adding Section 108.0026 to read as follows:
Sec. 108.0026. TRANSFER OF DUTIES; REFERENCE TO COUNCIL.
(a) The powers and duties of the Texas Health Care Information
Council under this chapter were transferred to the Department of
State Health Services in accordance with Section 1.19, Chapter 198
(H.B. 2292), Acts of the 78th Legislature, Regular Session, 2003.
(b) In this chapter or other law, a reference to the Texas
Health Care Information Council means the Department of State
Health Services.
SECTION 4. Subsection (h), Section 108.009, Health and
Safety Code, is amended to read as follows:
(h) The department [council] shall coordinate data
collection with the data submission formats used by hospitals and
other providers. The department [council] shall accept data in the
format developed by the American National Standards Institute
[National Uniform Billing Committee (Uniform Hospital Billing Form
UB 92) and HCFA-1500] or its successor [their successors] or other
nationally [universally] accepted standardized forms that
hospitals and other providers use for other complementary purposes.
SECTION 5. Section 108.013, Health and Safety Code, is
amended by amending Subsections (a), (b), (c), (d), (g), (i), and
(j) and adding Subsections (k), (l), (m), and (n) to read as
follows:
(a) The data received by the department under this chapter
[council] shall be used by the department [council] for the benefit
of the public. Subject to specific limitations established by this
chapter and executive commissioner [council] rule, the department
[council] shall make determinations on requests for information in
favor of access.
(b) The executive commissioner [council] by rule shall
designate the characters to be used as uniform patient identifiers.
The basis for assignment of the characters and the manner in which
the characters are assigned are confidential.
(c) Unless specifically authorized by this chapter, the
department [council] may not release and a person or entity may not
gain access to any data obtained under this chapter:
(1) that could reasonably be expected to reveal the
identity of a patient;
(2) that could reasonably be expected to reveal the
identity of a physician;
(3) disclosing provider discounts or differentials
between payments and billed charges;
(4) relating to actual payments to an identified
provider made by a payer; or
(5) submitted to the department [council] in a uniform
submission format that is not included in the public use data set
established under Sections 108.006(f) and (g), except in accordance
with Section 108.0135.
(d) Except as provided by this section, all [All] data
collected and used by the department [and the council] under this
chapter is subject to the confidentiality provisions and criminal
penalties of:
(1) Section 311.037;
(2) Section 81.103; and
(3) Section 159.002, Occupations Code.
(g) Except as provided by Subsection (i), the department
[The council] may not release data elements in a manner that will
reveal the identity of:
(1) a patient; or
(2) [. The council may not release data elements in a
manner that will reveal the identity of] a physician.
(i) Notwithstanding any other law, the [council and the]
department may [not] provide information made confidential by this
section to the Health and Human Services Commission or a health and
human services agency as defined by Section 531.001(4), Government
Code, provided that the receiving agency has appropriate controls
in place to ensure the confidentiality of any personal information
contained in the information shared by the department under this
subsection is subject to the limits on further disclosure described
by Subsection (d) [any other agency of this state].
(j) The executive commissioner [council] shall by rule[,
with the assistance of the advisory committee under Section
108.003(g)(5),] develop and implement a mechanism to comply with
Subsections (c)(1) and (2).
(k) The department may disclose data collected under this
chapter that is not included in public use data to any program
within the department if the disclosure is reviewed and approved by
the institutional review board under Section 108.0135.
(l) Confidential data collected under this chapter that is
disclosed to a program within the department remains subject to the
confidentiality provisions of this chapter and other applicable
law. The department shall identify the confidential data that is
disclosed to a program under Subsection (k). The program shall
maintain the confidentiality of the disclosed confidential data.
(m) The following provisions do not apply to the disclosure
of data to a department program:
(1) Section 81.103;
(2) Sections 108.010(g) and (h);
(3) Sections 108.011(e) and (f);
(4) Section 311.037; and
(5) Section 159.002, Occupations Code.
(n) Nothing in this section authorizes the disclosure of
physician identifying data.
SECTION 6. Section 108.0135, Health and Safety Code, is
amended to read as follows:
Sec. 108.0135. INSTITUTIONAL [SCIENTIFIC] REVIEW BOARD
[PANEL]. (a) The department [council] shall establish an
institutional [a scientific] review board [panel] to review and
approve requests for access to data not contained in [information
other than] public use data. The members of the institutional
review board must [panel shall] have experience and expertise in
ethics, patient confidentiality, and health care data.
(b) To assist the institutional review board [panel] in
determining whether to approve a request for information, the
executive commissioner [council] shall adopt rules similar to the
federal Centers for Medicare and Medicaid Services' [Health Care
Financing Administration's] guidelines on releasing data.
(c) A request for information other than public use data
must be made on the form prescribed [created] by the department
[council].
(d) Any approval to release information under this section
must require that the confidentiality provisions of this chapter be
maintained and that any subsequent use of the information conform
to the confidentiality provisions of this chapter.
SECTION 7. Subdivision (5), Section 108.002, Health and
Safety Code, is repealed.
SECTION 8. As soon as practicable after the effective date
of this Act and not later than December 1, 2011, the commissioner of
state health services and the commissioner of insurance shall
jointly appoint members to the Texas Bleeding Disorders Advisory
Council as required by Section 103A.002, Health and Safety Code, as
added by this Act.
SECTION 9. 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, 2011.
______________________________ ______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 156 passed the Senate on
March 17, 2011, by the following vote: Yeas 31, Nays 0;
May 24, 2011, Senate refused to concur in House amendments and
requested appointment of Conference Committee; May 26, 2011, House
granted request of the Senate; May 28, 2011, Senate adopted
Conference Committee Report by the following vote: Yeas 31,
Nays 0.
______________________________
Secretary of the Senate
I hereby certify that S.B. No. 156 passed the House, with
amendments, on May 17, 2011, by the following vote: Yeas 112,
Nays 34, one present not voting; May 26, 2011, House granted
request of the Senate for appointment of Conference Committee;
May 28, 2011, House adopted Conference Committee Report by the
following vote: Yeas 97, Nays 45, one present not voting.
______________________________
Chief Clerk of the House
Approved:
______________________________
Date
______________________________
Governor