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  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