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  H.B. No. 2641
 
 
 
 
AN ACT
  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 [2015].
         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