84R2044 KKR-D
By: Zedler H.B. No. 180
A BILL TO BE ENTITLED
AN ACT
relating to the confidentiality of certain information following
the completion of a review conducted by a utilization review agent
or an independent review organization.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 1305.355, Insurance Code, is amended by
adding Subsection (h) to read as follows:
(h) Notwithstanding Section 4202.009(a), following the
completion of an independent review requested under Subsection (a),
on written request to the independent review organization, a party
to the reviewed medical dispute is entitled to the name and
professional qualifications of any doctor or other health care
practitioner used to perform the independent review.
SECTION 2. Section 4201.557, Insurance Code, is amended to
read as follows:
Sec. 4201.557. REQUIREMENT TO MAINTAIN DATA IN CONFIDENTIAL
MANNER. (a) Except as provided by Subsection (b), a [A]
utilization review agent shall maintain all data concerning a
patient or physician or other health care provider in a
confidential manner that prevents unauthorized disclosure to a
third party.
(b) Following the completion of a utilization review
determination, on written request to the utilization review agent,
a patient, or a patient's representative, is entitled to the name
and professional qualifications of any physician or other
individual health care provider who made the utilization review
determination.
SECTION 3. Section 4202.009, Insurance Code, is amended to
read as follows:
Sec. 4202.009. CONFIDENTIAL INFORMATION. (a) Except as
provided by Subsection (b), information [Information] that reveals
the identity of a physician or other individual health care
provider who makes a review determination for an independent review
organization is confidential.
(b) Following the completion of an independent review
determination, on written request to the independent review
organization, a patient, as defined by Section 4201.002, or the
patient's representative, is entitled to the name and professional
qualifications of any physician or other individual health care
provider who made the independent review determination.
SECTION 4. The change in law made by this Act applies only
to a determination made by a utilization review agent or an
independent review organization with reference to a review that was
requested on or after the effective date of this Act. A
determination made by a utilization review agent or an independent
review organization with reference to a review that was requested
before the effective date of this Act is governed by the law in
effect immediately before the effective date of this Act, and that
law is continued in effect for that purpose.
SECTION 5. This Act takes effect September 1, 2015.