Bill Text: TX HB2641 | 2015-2016 | 84th Legislature | Enrolled
Bill Title: Relating to the exchange of health information in this state; creating a criminal offense.
Spectrum: Partisan Bill (Republican 4-0)
Status: (Passed) 2015-06-19 - Effective on 9/1/15 [HB2641 Detail]
Download: Texas-2015-HB2641-Enrolled.html
H.B. No. 2641 |
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relating to the exchange of health information in this state; | ||
creating a criminal offense. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Title 4, Civil Practice and Remedies Code, is | ||
amended by adding Chapter 74A to read as follows: | ||
CHAPTER 74A. LIMITATION OF LIABILITY RELATING TO HEALTH | ||
INFORMATION EXCHANGES | ||
Sec. 74A.001. DEFINITIONS. In this chapter: | ||
(1) "Gross negligence" has the meaning assigned by | ||
Section 41.001. | ||
(2) "Health care provider" means any individual, | ||
partnership, professional association, corporation, facility, or | ||
institution duly licensed, certified, registered, or chartered by | ||
this state to provide health care or medical care, including a | ||
physician. The term includes: | ||
(A) an officer, director, shareholder, member, | ||
partner, manager, owner, or affiliate of a physician or other | ||
health care provider; and | ||
(B) an employee, independent contractor, or | ||
agent of a physician or other health care provider acting in the | ||
course and scope of the employment or contractual relationship. | ||
(3) "Health information exchange" has the meaning | ||
assigned by Section 182.151, Health and Safety Code. The term | ||
includes: | ||
(A) an officer, director, shareholder, member, | ||
partner, manager, owner, or affiliate of the health information | ||
exchange; and | ||
(B) an employee, independent contractor, or | ||
agent of the health information exchange acting in the course and | ||
scope of the employment or contractual relationship. | ||
(4) "Malice" has the meaning assigned by Section | ||
41.001. | ||
(5) "Physician" means: | ||
(A) an individual licensed to practice medicine | ||
in this state under Subtitle B, Title 3, Occupations Code; | ||
(B) a professional association organized by an | ||
individual physician or a group of physicians; | ||
(C) a partnership or limited liability | ||
partnership formed by a group of physicians; | ||
(D) a limited liability company formed by a group | ||
of physicians; | ||
(E) a nonprofit health corporation certified by | ||
the Texas Medical Board under Chapter 162, Occupations Code; or | ||
(F) a single legal entity authorized to practice | ||
medicine in this state owned by a group of physicians. | ||
Sec. 74A.002. LIMITATION ON LIABILITY OF HEALTH CARE | ||
PROVIDERS RELATING TO HEALTH INFORMATION EXCHANGES. (a) Unless the | ||
health care provider acts with malice or gross negligence, a health | ||
care provider who provides patient information to a health | ||
information exchange is not liable for any damages, penalties, or | ||
other relief related to the obtainment, use, or disclosure of that | ||
information in violation of federal or state privacy laws by a | ||
health information exchange, another health care provider, or any | ||
other person. | ||
(b) Nothing in this section may be construed to create a | ||
cause of action or to create a standard of care, obligation, or duty | ||
that forms the basis for a cause of action. | ||
Sec. 74A.003. APPLICABILITY OF OTHER LAW. The protections, | ||
immunities, and limitations of liability provided by this chapter | ||
are in addition to any other protections, immunities, and | ||
limitations of liability provided by other law. | ||
SECTION 2. Section 531.0162, Government Code, is amended by | ||
adding Subsections (e), (f), (g), and (h) to read as follows: | ||
(e) The executive commissioner shall ensure that: | ||
(1) all information systems available for use by the | ||
commission or a health and human services agency in sending | ||
protected health information to a health care provider or receiving | ||
protected health information from a health care provider, and for | ||
which planning or procurement begins on or after September 1, 2015, | ||
are capable of sending or receiving that information in accordance | ||
with the applicable data exchange standards developed by the | ||
appropriate standards development organization accredited by the | ||
American National Standards Institute; | ||
(2) if national data exchange standards do not exist | ||
for a system described by Subdivision (1), the commission makes | ||
every effort to ensure the system is interoperable with the | ||
national standards for electronic health record systems; and | ||
(3) the commission and each health and human services | ||
agency establish an interoperability standards plan for all | ||
information systems that exchange protected health information | ||
with health care providers. | ||
(f) Not later than December 1 of each even-numbered year, | ||
the executive commissioner shall report to the governor and the | ||
Legislative Budget Board on the commission's and the health and | ||
human services agencies' measurable progress in ensuring that the | ||
information systems described in Subsection (e) are interoperable | ||
with one another and meet the appropriate standards specified by | ||
that subsection. The report must include an assessment of the | ||
progress made in achieving commission goals related to the exchange | ||
of health information, including facilitating care coordination | ||
among the agencies, ensuring quality improvement, and realizing | ||
cost savings. | ||
(g) The executive commissioner by rule may develop and the | ||
commission may implement a system to reimburse providers of health | ||
care services under the state Medicaid program for review and | ||
transmission of electronic health information if feasible and | ||
cost-effective. | ||
(h) In this section, "health care provider" and "provider of | ||
health care services" include a physician. | ||
SECTION 3. Section 531.02176, Government Code, as amended | ||
by S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, is | ||
amended to read as follows: | ||
Sec. 531.02176. EXPIRATION OF MEDICAID REIMBURSEMENT FOR | ||
PROVISION OF HOME TELEMONITORING SERVICES. Notwithstanding any | ||
other law, the commission may not reimburse providers under | ||
Medicaid for the provision of home telemonitoring services on or | ||
after September 1, 2019 [ |
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SECTION 4. Section 81.044(a), Health and Safety Code, as | ||
amended by S.B. 219, Acts of the 84th Legislature, Regular Session, | ||
2015, is amended to read as follows: | ||
(a) The executive commissioner shall prescribe the form and | ||
method of reporting under this chapter, which may be in writing, by | ||
telephone, by electronic data transmission, through a health | ||
information exchange as defined by Section 182.151 if requested and | ||
authorized by the person required to report, or by other means. | ||
SECTION 5. Section 82.008(a), Health and Safety Code, as | ||
amended by S.B. 219, Acts of the 84th Legislature, Regular Session, | ||
2015, is amended to read as follows: | ||
(a) To ensure an accurate and continuing source of data | ||
concerning cancer, each health care facility, clinical laboratory, | ||
and health care practitioner shall furnish to the department, on | ||
request, data the executive commissioner considers necessary and | ||
appropriate that is derived from each medical record pertaining to | ||
a case of cancer that is in the custody or under the control of the | ||
health care facility, clinical laboratory, or health care | ||
practitioner. The department may not request data that is more than | ||
three years old unless the department is investigating a possible | ||
cancer cluster. At the request and with the authorization of the | ||
applicable health care facility, clinical laboratory, or health | ||
care practitioner, data may be furnished to the department through | ||
a health information exchange as defined by Section 182.151. | ||
SECTION 6. Section 161.007(d), Health and Safety Code, is | ||
amended to read as follows: | ||
(d) A health care provider who administers an immunization | ||
to an individual younger than 18 years of age shall provide data | ||
elements regarding an immunization to the department. A health | ||
care provider who administers an immunization to an individual 18 | ||
years of age or older may submit data elements regarding an | ||
immunization to the department. At the request and with the | ||
authorization of the health care provider, the data elements may be | ||
submitted through a health information exchange as defined by | ||
Section 182.151. The data elements shall be submitted in a format | ||
prescribed by the department. The department shall verify consent | ||
before including the information in the immunization registry. The | ||
department may not retain individually identifiable information | ||
about an individual for whom consent cannot be verified. | ||
SECTION 7. Section 161.00705(a), Health and Safety Code, is | ||
amended to read as follows: | ||
(a) The department shall maintain a registry of persons who | ||
receive an immunization, antiviral, and other medication | ||
administered to prepare for a potential disaster, public health | ||
emergency, terrorist attack, hostile military or paramilitary | ||
action, or extraordinary law enforcement emergency or in response | ||
to a declared disaster, public health emergency, terrorist attack, | ||
hostile military or paramilitary action, or extraordinary law | ||
enforcement emergency. A health care provider who administers an | ||
immunization, antiviral, or other medication shall provide the data | ||
elements to the department. At the request and with the | ||
authorization of the health care provider, the data elements may be | ||
provided through a health information exchange as defined by | ||
Section 182.151. | ||
SECTION 8. Section 161.00706(b), Health and Safety Code, is | ||
amended to read as follows: | ||
(b) A health care provider, on receipt of a request under | ||
Subsection (a)(1), shall submit the data elements to the department | ||
in a format prescribed by the department. At the request and with | ||
the authorization of the health care provider, the data elements | ||
may be submitted through a health information exchange as defined | ||
by Section 182.151. The department shall verify the person's | ||
request before including the information in the immunization | ||
registry. | ||
SECTION 9. Section 161.0073(c), Health and Safety Code, is | ||
amended to read as follows: | ||
(c) A person required to report information to the | ||
department for registry purposes or authorized to receive | ||
information from the registry may not disclose the individually | ||
identifiable information of an individual to any other person | ||
without the written or electronic consent of the individual or the | ||
individual's legally authorized representative, except as provided | ||
by Sections 161.007, 161.00705, 161.00706, and 161.008 of this | ||
code, Chapter 159, Occupations Code, or Section 602.053, Insurance | ||
Code. | ||
SECTION 10. Section 161.008, Health and Safety Code, is | ||
amended by adding Subsection (i) to read as follows: | ||
(i) At the request and with the authorization of the | ||
applicable health care provider, immunization history or data may | ||
be submitted to or obtained by the department through a health | ||
information exchange as defined by Section 182.151. | ||
SECTION 11. Chapter 182, Health and Safety Code, is amended | ||
by adding Subchapter D to read as follows: | ||
SUBCHAPTER D. HEALTH INFORMATION EXCHANGES | ||
Sec. 182.151. DEFINITION. In this subchapter, "health | ||
information exchange" means an organization that: | ||
(1) assists in the transmission or receipt of | ||
health-related information among organizations transmitting or | ||
receiving the information according to nationally recognized | ||
standards and under an express written agreement with the | ||
organizations; | ||
(2) as a primary business function, compiles or | ||
organizes health-related information designed to be securely | ||
transmitted by the organization among physicians, other health care | ||
providers, or entities within a region, state, community, or | ||
hospital system; or | ||
(3) assists in the transmission or receipt of | ||
electronic health-related information among physicians, other | ||
health care providers, or entities within: | ||
(A) a hospital system; | ||
(B) a physician organization; | ||
(C) a health care collaborative, as defined by | ||
Section 848.001, Insurance Code; | ||
(D) an accountable care organization | ||
participating in the Pioneer Model under the initiative by the | ||
Innovation Center of the Centers for Medicare and Medicaid | ||
Services; or | ||
(E) an accountable care organization | ||
participating in the Medicare Shared Savings Program under 42 | ||
U.S.C. Section 1395jjj. | ||
Sec. 182.152. AUTHORITY OF HEALTH INFORMATION EXCHANGE. | ||
(a) Notwithstanding Sections 81.046, 82.009, 161.0073, and | ||
161.008, a health information exchange may access and transmit | ||
health-related information under Sections 81.044(a), 82.008(a), | ||
161.007(d), 161.00705(a), 161.00706(b), and 161.008(i) if the | ||
access or transmittal is: | ||
(1) made for the purpose of assisting in the reporting | ||
of health-related information to the appropriate agency; | ||
(2) requested and authorized by the appropriate health | ||
care provider, practitioner, physician, facility, clinical | ||
laboratory, or other person who is required to report | ||
health-related information; | ||
(3) made in accordance with the applicable consent | ||
requirements for the immunization registry under Subchapter A, | ||
Chapter 161, if the information being accessed or transmitted | ||
relates to the immunization registry; and | ||
(4) made in accordance with the requirements of this | ||
subchapter and all other state and federal law. | ||
(b) A health information exchange may only use and disclose | ||
the information that it accesses or transmits under Subsection (a) | ||
in compliance with this subchapter and all applicable state and | ||
federal law, and may not exchange, sell, trade, or otherwise make | ||
any prohibited use or disclosure of the information. | ||
Sec. 182.153. COMPLIANCE WITH LAW; SECURITY. A health | ||
information exchange that collects, transmits, disseminates, | ||
accesses, or reports health-related information under this | ||
subchapter shall comply with all applicable state and federal law, | ||
including secure electronic data submission requirements. | ||
Sec. 182.154. CRIMINAL PENALTY. (a) A person who collects, | ||
transmits, disseminates, accesses, or reports information under | ||
this subchapter on behalf of or as a health information exchange | ||
commits an offense if the person, with the intent to violate this | ||
subchapter, allows health-related information in the possession of | ||
a health information exchange to be used or disclosed in a manner | ||
that violates this subchapter. | ||
(b) An offense under this section is a Class A misdemeanor. | ||
Sec. 182.155. IMMUNITIES AND DEFENSES CONTINUED. | ||
Collecting, transmitting, disseminating, accessing, or reporting | ||
information through a health information exchange does not alone | ||
deprive a physician or health care provider of an otherwise | ||
applicable immunity or defense. | ||
SECTION 12. Chapter 74A, Civil Practice and Remedies Code, | ||
as added by this Act, applies only to a cause of action that accrues | ||
on or after the effective date of this Act. A cause of action that | ||
accrues 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 13. This Act takes effect September 1, 2015. | ||
______________________________ | ______________________________ | |
President of the Senate | Speaker of the House | |
I certify that H.B. No. 2641 was passed by the House on May | ||
15, 2015, by the following vote: Yeas 120, Nays 5, 2 present, not | ||
voting; that the House refused to concur in Senate amendments to | ||
H.B. No. 2641 on May 27, 2015, and requested the appointment of a | ||
conference committee to consider the differences between the two | ||
houses; and that the House adopted the conference committee report | ||
on H.B. No. 2641 on May 31, 2015, by the following vote: Yeas 127, | ||
Nays 17, 2 present, not voting. | ||
______________________________ | ||
Chief Clerk of the House | ||
I certify that H.B. No. 2641 was passed by the Senate, with | ||
amendments, on May 25, 2015, by the following vote: Yeas 30, Nays | ||
1; at the request of the House, the Senate appointed a conference | ||
committee to consider the differences between the two houses; and | ||
that the Senate adopted the conference committee report on H.B. No. | ||
2641 on May 30, 2015, by the following vote: Yeas 31, Nays 0. | ||
______________________________ | ||
Secretary of the Senate | ||
APPROVED: __________________ | ||
Date | ||
__________________ | ||
Governor |