| 1 | 1 | | 83R2088 KCR-D |
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| 2 | 2 | | By: Zedler H.B. No. 287 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to the confidentiality of certain information following |
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| 8 | 8 | | the completion of a review conducted by an independent review |
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| 9 | 9 | | organization. |
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| 10 | 10 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 11 | 11 | | SECTION 1. Section 1305.355, Insurance Code, is amended by |
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| 12 | 12 | | adding Subsection (h) to read as follows: |
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| 13 | 13 | | (h) Notwithstanding Section 4202.009(a), Insurance Code, |
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| 14 | 14 | | following the completion of an independent review under Subsection |
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| 15 | 15 | | (a), on written request to the utilization review agent or |
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| 16 | 16 | | independent review organization, a party to the reviewed medical |
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| 17 | 17 | | dispute is entitled to the name and professional qualifications of |
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| 18 | 18 | | any doctor or other health care practitioner used to perform the |
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| 19 | 19 | | review. |
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| 20 | 20 | | SECTION 2. Section 4202.009, Insurance Code, is amended to |
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| 21 | 21 | | read as follows: |
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| 22 | 22 | | Sec. 4202.009. CONFIDENTIAL INFORMATION. (a) Except as |
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| 23 | 23 | | provided by Subsection (b), information [Information] that reveals |
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| 24 | 24 | | the identity of a physician or other individual health care |
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| 25 | 25 | | provider who makes a review determination for an independent review |
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| 26 | 26 | | organization is confidential. |
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| 27 | 27 | | (b) Following the completion of a review determination, on |
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| 28 | 28 | | written request to the utilization review agent or independent |
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| 29 | 29 | | review organization, a party that sought the independent review of |
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| 30 | 30 | | the adverse determination is entitled to the name and professional |
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| 31 | 31 | | qualifications of any physician or other individual health care |
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| 32 | 32 | | provider who made the review determination. |
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| 33 | 33 | | SECTION 3. The change in law made by this Act applies only |
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| 34 | 34 | | to a determination made by an independent review organization with |
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| 35 | 35 | | reference to a review that was requested on or after the effective |
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| 36 | 36 | | date of this Act. A determination made by an independent review |
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| 37 | 37 | | organization with reference to a review that was requested before |
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| 38 | 38 | | the effective date of this Act is governed by the law in effect |
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| 39 | 39 | | immediately before the effective date of this Act, and that law is |
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| 40 | 40 | | continued in effect for that purpose. |
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| 41 | 41 | | SECTION 4. This Act takes effect September 1, 2013. |
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