Health and Safety Code
CHAPTER 108. TEXAS HEALTH CARE INFORMATION COUNCIL.
Sec. 108.001. Creation of Council.
The Texas Health Care Information Council shall administer this
chapter and report to the governor, the legislature, and the
public.
Added by Acts 1995, 74th Leg., ch. 726, Sec. 1, eff. Sept. 1,
1995.
Sec. 108.002. Definitions.
In this chapter:
(1) "Board" means the Texas Board of Health.
(2) "Charge" or "rate" means the amount billed by a provider
for specific procedures or services provided to a patient
before any adjustment for contractual allowances. The term
does not include copayment charges to enrollees in health
benefit plans charged by providers paid by capitation or
salary.
(3) "Council" means the Texas Health Care Information
Council.
(4) "Data" means information collected under Section 108.009
in the form initially received.
(5) "Department" means the Texas Department of Health.
(6) "Health benefit plan" means a plan provided by:
(A) a health maintenance organization; or
(B) an approved nonprofit health corporation that is
certified under Section 5.01(a), Medical Practice Act
(Article 4495b, Vernon's Texas Civil Statutes), and that
holds a certificate of authority issued by the commissioner
of insurance under Article 21.52F, Insurance Code.
(7) "Health care facility" means:
(A) a hospital;
(B) an ambulatory surgical center licensed under Chapter
243;
(C) a chemical dependency treatment facility licensed
under Chapter 464;
(D) a renal dialysis facility;
(E) a birthing center;
(F) a rural health clinic; or
(G) a federally qualified health center as defined by 42
U.S.C. Section 1396d(l)(2)(B).
(8) "Health maintenance organization" means an organization
as defined in Section 2, Texas Health Maintenance Organization
Act (Article 20A.02, Vernon's Texas Insurance Code).
(9) "Hospital" means a public, for-profit, or nonprofit
institution licensed or owned by this state that is a general
or special hospital, private mental hospital, chronic disease
hospital, or other type of hospital.
(10) "Outcome data" means measures related to the provision
of care, including:
(A) patient demographic information;
(B) patient length of stay;
(C) mortality;
(D) co-morbidity;
(E) complications; and
(F) charges.
(11) "Physician" means an individual licensed under the laws
of this state to practice medicine under the Medical Practice
Act (Article 4495b, Vernon's Texas Civil Statutes).
(12) "Provider" means a physician or health care facility.
(13) "Provider quality" means the extent to which a provider
renders care that, within the capabilities of modern medicine,
obtains for patients medically acceptable health outcomes and
prognoses, after severity adjustment.
(14) "Public use data" means patient level data relating to
individual hospitalizations that has not been summarized or
analyzed, that identifies patients and physicians only by use
of uniform patient and physician identifiers, and that is
severity and risk adjusted and verified for accuracy.
(15) "Rural provider" means a provider described by Section
108.0025.
(16) "Severity adjustment" means a method to stratify
patient groups by degrees of illness and mortality.
(17) "Uniform patient identifier" means a number assigned by
the council to an individual patient and composed of numeric,
alpha, or alphanumeric characters.
(18) "Uniform physician identifier" means a number assigned
by the council to an individual physician and composed of
numeric, alpha, or alphanumeric characters.
Added by Acts 1995, 74th Leg., ch. 726, Sec. 1, eff. Sept. 1,
1995. Amended by Acts 1997, 75th Leg., ch. 261, Sec. 1, eff.
Sept. 1, 1997.
Sec. 108.0025. Rural Provider.
For purposes of this chapter, a provider is a rural provider if
the provider:
(1) is located in a county that:
(A) has a population estimated by the United States
Bureau of the Census to be not more than 35,000 as of July 1
of the most recent year for which county population
estimates have been published; or
(B) has a population of more than 35,000, but that does
not have more than 100 licensed hospital beds and is not
located in an area that is delineated as an urbanized area
by the United States Bureau of the Census; and
(2) is not a state-owned hospital or a hospital that is
managed or directly or indirectly owned by an individual,
association, partnership, corporation, or other legal entity
that owns or manages one or more other hospitals.
Added by Acts 1997, 75th Leg., ch. 261, Sec. 2, eff. Sept. 1,
1997.
Sec. 108.003. Council Composition; Expenses.
(a) The council is composed of four ex officio state agency
members and 15 members appointed by the governor in accordance
with this section.
(b) The ex officio members of the council are:
(1) the commissioner of public health or the commissioner's
designee;
(2) the commissioner of health and human services or the
commissioner's designee;
(3) the commissioner of insurance or the commissioner's
designee; and
(4) the public insurance counsel or the counsel's designee.
(c) The governor shall appoint the following members of the
council:
(1) three representatives of the business community, with at
least one representing small businesses, who are purchasers of
health care but who are not involved in the provision of health
care or health insurance;
(2) two representatives from labor, one of whom is not
directly involved with management of health care benefits;
(3) two representatives of consumers who are not
professionally involved in the purchase, provision,
administration, or review of health care or health care
insurance;
(4) two representatives of hospitals;
(5) one representative of health maintenance organizations;
(6) three representatives of physicians who are involved in
direct patient care; and
(7) two members who are not professionally involved in the
purchase, provision, administration, or utilization review of
health care or health care insurance and who have expertise in:
(A) health planning;
(B) health economics;
(C) provider quality assurance;
(D) information systems; or
(E) the reimbursement of medical education and research
costs.
(d) The chairman is appointed by and serves at the pleasure of
the governor. Members annually shall elect a vice chairman.
(e) A majority of voting members constitutes a quorum for the
transaction of any business. An act by the majority of the
voting members present at any meeting at which there is a quorum
is considered to be an act of the council.
(f) The council may appoint committees and may elect any
officers subordinate to those provided for in Subsection (d).
(g) The council shall appoint technical advisory committees and
shall consult with the appropriate technical advisory committee
with respect to a rule before the rule is finally adopted by the
council. The council is not required to consult with a technical
advisory committee before adopting an emergency rule in
accordance with Section 2001.034, Government Code. The council
shall submit an emergency rule adopted by the council to the
appropriate advisory committee for review not later than the
first advisory committee meeting that occurs after the rule is
adopted. The council may consult with the appropriate technical
advisory committee with respect to other formal action of the
council. A technical advisory committee may consult with other
professionals as necessary. The technical advisory committees
shall include:
(1) a technical advisory committee that includes, among
other individuals, at least five practicing physicians licensed
in this state to provide advice and recommendations to the
council on:
(A) the development and implementation of the
methodology and the interpretation of provider quality data
under Section 108.010; and
(B) the development and dissemination of consumer
education information and materials;
(2) a technical advisory committee composed of at least five
practicing physicians licensed in this state who have been
actively engaged in organized peer review at a hospital in this
state to provide advice, recommendations, and peer review
expertise to the council on:
(A) the use of peer review in the determination of
quality inpatient care;
(B) the development and interpretation of data elements
necessary to the determination of quality inpatient care;
and
(C) the development and format of reports and
information relating to provider quality;
(3) a technical advisory committee composed of individuals
who have expertise in the reimbursement of medical education
and research costs;
(4) a technical advisory committee composed of
representatives of each type of issuer of health benefit plans
to assist the council in complying with Section 108.009(o); and
(5) a technical advisory committee composed of individuals
who have expertise in hospital information systems, health
information management, and quality management.
(h) A member of the council may not receive compensation for
service on the council. However, the member shall be reimbursed
for the member's actual and necessary meals, lodging,
transportation, and incidental expenses if incurred while
performing council business.
(i) A member of an advisory committee appointed by the council
may not receive compensation or reimbursement of any expense
incurred while serving on the committee.
(j) Appointments to the council shall be made without regard to
the race, color, disability, sex, religion, age, or national
origin of appointees. Additionally, in making the appointments
to the council, the governor shall consider geographical
representation.
(k) A person may not serve as a member of the council if the
person is required to register as a lobbyist under Chapter 305,
Government Code, because of the person's activities for
compensation on behalf of a profession related to the operation
of the council.
Added by Acts 1995, 74th Leg., ch. 726, Sec. 1, eff. Sept. 1,
1995. Amended by Acts 1997, 75th Leg., ch. 261, Sec. 3, eff.
Sept. 1, 1997.
Sec. 108.004. Meetings.
(a) The council, council committees, and technical advisory
committees are subject to the open meetings law, Chapter 551,
Government Code.
(b) The council shall meet as often as necessary, but not less
often than quarterly, to perform its duties under this chapter.
(c) The council shall publish a notice of its meetings in the
Texas Register.
Added by Acts 1995, 74th Leg., ch. 726, Sec. 1, eff. Sept. 1,
1995. Amended by Acts 1997, 75th Leg., ch. 261, Sec. 4, eff.
Sept. 1, 1997.
Sec. 108.0045. Open Records.
Subject to the restrictions of this chapter, the council is
subject to the open records law, Chapter 552, Government Code.
Added by Acts 1997, 75th Leg., ch. 261, Sec. 5, eff. Sept. 1,
1997.
Sec. 108.005. Terms.
(a) The terms of the agency members are concurrent with their
terms of office. The appointed council members serve six-year
staggered terms, with the terms of five members expiring
September 1 of each odd-numbered year.
(b) An appointed member may not serve more than two full
consecutive terms.
(c) It is a ground for removal from the council if a member of
the council:
(1) does not have at the time of appointment the
qualifications required by Section 108.003;
(2) does not maintain during service the qualifications
required by Section 108.003;
(3) cannot discharge the member's duties for a substantial
part of the term for which the member is appointed because of
illness or disability; or
(4) fails to attend at least one-half of the regularly
scheduled meetings that the member is eligible to attend during
a calendar year.
Added by Acts 1995, 74th Leg., ch. 726, Sec. 1, eff. Sept. 1,
1995.
Sec. 108.006. Powers and Duties of Council.
(a) The council shall develop a statewide health care data
collection system to collect health care charges, utilization
data, provider quality data, and outcome data to facilitate the
promotion and accessibility of cost-effective, good quality
health care. The council shall:
(1) direct the collection, dissemination, and analysis of
data under this chapter;
(2) contract with the department to collect the data under
this chapter;
(3) adopt policies and rules necessary to carry out this
chapter, including rules concerning data collection
requirements;
(4) build on and not duplicate other data collection
required by state or federal law, by an accreditation
organization, or by board rule;
(5) working with appropriate agencies, review public health
data collection programs in this state and recommend, where
appropriate, consolidation of the programs and any legislation
necessary to effect the consolidation;
(6) assure that public use data is made available and
accessible to interested persons;
(7) prescribe by rule the process for providers to submit
data consistent with Section 108.009;
(8) adopt by rule and implement a methodology to collect and
disseminate data reflecting provider quality in accordance with
Section 108.010;
(9) make reports to the legislature, the governor, and the
public on:
(A) the charges and rate of change in the charges for
health care services in this state;
(B) the effectiveness of the council in carrying out the
legislative intent of this chapter;
(C) if applicable, any recommendations on the need for
further legislation; and
(D) the quality and effectiveness of health care and
access to health care for all citizens of this state;
(10) develop an annual work plan and establish priorities to
accomplish its duties;
(11) provide consumer education on the interpretation and
understanding of the public use or provider quality data before
the data is disseminated to the public;
(12) work with the Health and Human Services Commission and
each health and human services agency that administers a part
of the state Medicaid program to avoid duplication of
expenditures of state funds for computer systems, staff, or
services in the collection and analysis of data relating to the
state Medicaid program;
(13) work with the Department of Information Resources in
developing and implementing the statewide health care data
collection system and maintain consistency with Department of
Information Resources standards; and
(14) develop and implement a health care information plan to
be used by the department to:
(A) support public health and preventative health
initiatives;
(B) assist in the delivery of primary and preventive
health care services;
(C) facilitate the establishment of appropriate
benchmark data to measure performance improvements;
(D) establish and maintain a systematic approach to the
collection, storage, and analysis of health care data for
longitudinal, epidemiological, and policy impact studies;
and
(E) develop and use system-based protocols to identify
individuals and populations at risk.
(b) The council may:
(1) employ or contract with the department to employ an
executive director and other staff, including administrative
personnel, necessary to comply with this chapter and rules
adopted under this chapter;
(2) engage professional consultants as it considers
necessary to the performance of its duties;
(3) adopt rules clarifying which health care facilities must
provide data under this chapter; and
(4) apply for and receive any appropriation, donation, or
other funds from the state or federal government or any other
public or private source, subject to Section 108.015 and
limitations and conditions provided by legislative
appropriation.
(c) The council may not establish or recommend rates of payment
for health care services.
(d) The council may not take an action that affects or relates
to the validity, status, or terms of an interagency agreement or
a contract with the department without the board's approval.
(e) In the collection of data, the council shall consider the
research and initiatives being pursued by the United States
Department of Health and Human Services, the National Committee
for Quality Assurance, and the Joint Commission on Accreditation
of Healthcare Organizations to reduce potential duplication or
inconsistencies. The council may not adopt rules that conflict
with or duplicate any federally mandated data collection programs
or requirements of comparable scope.
Added by Acts 1995, 74th Leg., ch. 726, Sec. 1, eff. Sept. 1,
1995. Amended by Acts 1997, 75th Leg., ch. 261, Sec. 6, eff.
Sept. 1, 1997.
Sec. 108.007. Review Powers.
(a) The council, through the department and subject to
reasonable rules and guidelines, may:
(1) inspect documents and records used by data sources that
are required to compile data and reports; and
(2) compel providers to produce accurate documents and
records.
(b) The council may enter into a memorandum of understanding
with a state agency, including the division of the Health and
Human Services Commission responsible for the state Medicaid
program, or with a school of public health or another institution
of higher education, to share data and expertise, to obtain data
for the council, or to make data available to the council. An
agreement entered into under this subsection must protect patient
confidentiality.
Added by Acts 1995, 74th Leg., ch. 726, Sec. 1, eff. Sept. 1,
1995.
Sec. 108.008. Duties of Department.
(a) The department, as the state health planning and
development agency under Chapter 104, is responsible for the
collection of data under Chapter 311.
(b) The department shall:
(1) contract with the council to collect data under this
chapter;
(2) provide administrative assistance to the council;
(3) coordinate administrative responsibilities with the
council to avoid unnecessary duplication of the collection of
data and other duties;
(4) on request of the council, give the council access to
data collected by the department;
(5) submit or assist in the council's budget request to the
legislature; and
(6) work with the Department of Information Resources in
developing and implementing the statewide health care data
collection system and maintain consistency with Department of
Information Resources standards.
(c) The department may not take an action that affects or
relates to the validity, status, or terms of an interagency
agreement or a contract with the council without the council's
approval.
Added by Acts 1995, 74th Leg., ch. 726, Sec. 1, eff. Sept. 1,
1995. Amended by Acts 1997, 75th Leg., ch. 261, Sec. 7, eff.
Sept. 1, 1997.
Sec. 108.0081. Memorandum of Understanding.
The council and the department shall enter into a memorandum of
understanding to implement the department's duties under Section
108.008(b). The memorandum of understanding must address:
(1) payroll and travel reimbursement services;
(2) purchasing services;
(3) personnel services;
(4) budget management services;
(5) computer support and maintenance services;
(6) meeting coordination services;
(7) any other administrative support or other services to be
provided by the department for the council; and
(8) the manner in which the council will reimburse the
department for the cost of services provided by the department
for the council.
Added by Acts 1997, 75th Leg., ch. 261, Sec. 8, eff. Sept. 1,
1997.
Sec. 108.0085. Duties of Attorney General.
The attorney general shall furnish the council with advice and
legal assistance that may be required to implement this chapter.
Added by Acts 1997, 75th Leg., ch. 261, Sec. 8, eff. Sept. 1,
1997.
Sec. 108.009. Data Submission and Collection.
(a) The council may collect, and, except as provided by
Subsections (c) and (d), providers shall submit to the council or
another entity as determined by the council, all data required by
this section. The data shall be collected according to uniform
submission formats, coding systems, and other technical
specifications necessary to make the incoming data substantially
valid, consistent, compatible, and manageable using electronic
data processing, if available.
(b) The council shall adopt rules to implement the data
submission requirements imposed by Subsection (a) in appropriate
stages to allow for the development of efficient systems for the
collection and submission of the data. A rule adopted by the
council that requires submission of a data element that, before
adoption of the rule, was not required to be submitted may not
take effect before the 90th day after the date the rule is
adopted.
(c) A rural provider may, but is not required to, provide the
data required by this chapter. A hospital may, but is not
required to, provide the data required by this chapter if the
hospital:
(1) is exempt from state franchise, sales, ad valorem, or
other state or local taxes; and
(2) does not seek or receive reimbursement for providing
health care services to patients from any source, including:
(A) the patient or any person legally obligated to
support the patient;
(B) a third-party payor; or
(C) Medicaid, Medicare, or any other federal, state, or
local program for indigent health care.
(d) The council may not collect data from individual physicians
or from an entity that is composed entirely of physicians and
that is a professional association organized under the Texas
Professional Association Act (Article 1528f, Vernon's Texas Civil
Statutes), a limited liability partnership organized under
Section 3.08, Texas Revised Partnership Act (Article 6132b-3.08,
Vernon's Texas Civil Statutes), or a limited liability company
organized under the Texas Limited Liability Company Act (Article
1528n, Vernon's Texas Civil Statutes), except to the extent the
entity owns and operates a health care facility in this state.
This subsection does not prohibit the release of data about
physicians using uniform physician identifiers that has been
collected from a health care facility under this chapter.
(e) The council shall establish the department as the single
collection point for receipt of data from providers. With the
approval of the council and the board, the department may
transfer collection of any data required to be collected by the
department under any other law to the statewide health care data
collection system.
(f) The council may not require providers to submit data more
frequently than quarterly, but providers may submit data on a
more frequent basis.
(g) The council shall coordinate data collection with the data
collection formats used by federally qualified health centers.
To satisfy the requirements of this chapter:
(1) a federally qualified health center shall submit
annually to the council a copy of the Medicaid cost report of
federally qualified health centers; and
(2) a provider receiving federal funds under 42 U.S.C.
Section 254b, 254c, or 256 shall submit annually to the council
a copy of the Bureau of Common Reporting Requirements data
report developed by the United States Public Health Service.
(h) The council shall coordinate data collection with the data
submission formats used by hospitals and other providers. The
council shall accept data in the format developed by the National
Uniform Billing Committee (Uniform Hospital Billing Form UB 92)
and HCFA-1500 or their successors or other universally accepted
standardized forms that hospitals and other providers use for
other complementary purposes.
(i) The council shall develop by rule reasonable alternate data
submission procedures for providers that do not possess
electronic data processing capacity.
(j) Repealed by Acts 1997, 75th Leg., ch. 261, Sec. 14, eff.
Sept. 1, 1997.
(k) The council shall collect health care data elements
relating to payer type, the racial and ethnic background of
patients, and the use of health care services by consumers.
(l) Repealed by Acts 1997, 75th Leg., ch. 261, Sec. 14, eff.
Sept. 1, 1997.
(m) To the extent feasible, the council shall obtain from
public records the information that is available from those
records.
(n) Repealed by Acts 1997, 75th Leg., ch. 261, Sec. 14, eff.
Sept. 1, 1997.
(o) A provider of a health benefit plan shall annually submit
to the council aggregate data by service area required by the
Health Plan Employer Data Information Set (HEDIS) as operated by
the National Committee for Quality Assurance. The council may
approve the submission of data in accordance with other methods
generally used by the health benefit plan industry. If the
Health Plan Employer Data Information Set does not generally
apply to a health benefit plan, the council shall require
submission of data in accordance with other methods. This
subsection does not relieve a health care facility that provides
services under a health benefit plan from the requirements of
this chapter. Information submitted under this section is
subject to Section 108.011 but is not subject to Section 108.010.
Added by Acts 1995, 74th Leg., ch. 726, Sec. 1, eff. Sept. 1,
1995. Amended by Acts 1997, 75th Leg., ch. 261, Secs. 9, 14,
eff. Sept. 1, 1997.
Sec. 108.010. Collection and Dissemination of Provider Quality Data.
(a) Subject to Section 108.009, the council shall collect data
reflecting provider quality based on a methodology and review
process established through the council's rulemaking process.
The methodology shall identify and measure quality standards and
adhere to any federal mandates.
(b) The council shall study and analyze initial methodologies
for obtaining provider quality data, including outcome data.
(c) The council shall test the methodology by collecting
provider quality data for one year, subject to Section 108.009.
The council may test using pilot methodologies. After collecting
provider quality data for one year, the council shall report
findings applicable to a provider to that provider and allow the
provider to review and comment on the initial provider quality
data applicable to that provider. The council shall verify the
accuracy of the data during this review and revision process.
After the review and revision process, provider quality data for
subsequent reports shall be published and made available to the
public, on a time schedule the council considers appropriate.
(d) If the council determines that provider quality data to be
published under Subsection (c) does not provide the intended
result or is inaccurate or inappropriate for dissemination, the
council is not required to publish the data or reports based in
whole or in part on the data. This subsection does not affect
the release of public use data in accordance with Section 108.011
or the release of information submitted under Section 108.009(o).
(e) The council shall adopt rules allowing a provider to submit
concise written comments regarding any specific provider quality
data to be released concerning the provider. The council shall
make the comments available to the public at the office of the
council and in an electronic form accessible through the
Internet. The comments shall be attached to any public release
of provider quality data. Providers shall submit the comments to
the council to be attached to the public release of provider
quality data in the same format as the provider quality data that
is to be released.
(f) The methodology adopted by the council for measuring
quality shall include case-mix qualifiers, severity adjustment
factors, adjustments for medical education and research, and any
other factors necessary to accurately reflect provider quality.
(g) In addition to the requirements of this section, any
release of provider quality data shall comply with Sections
108.011(e) and (f).
(h) A provider quality data report may not identify an
individual physician by name, but must identify the physician by
the uniform physician identifier designated by the council under
Section 108.011(c).
(i) The council shall release provider quality data relating to
providers described by Section 108.0025(1), but that are not
rural providers because they do not meet the requirement of
Section 108.0025(2), in an aggregate form without uniform patient
and physician identifiers.
Added by Acts 1995, 74th Leg., ch. 726, Sec. 1, eff. Sept. 1,
1995. Amended by Acts 1997, 75th Leg., ch. 261, Sec. 10, eff.
Sept. 1, 1997.
Sec. 108.011. Dissemination of Public Use Data and Council Publications.
(a) The council shall promptly provide public use data and data
collected in accordance with Section 108.009(o) to those
requesting it. The public use data does not include provider
quality data prescribed by Section 108.010 or confidential data
prescribed by Section 108.013.
(b) Subject to the restrictions on access to council data
prescribed by Sections 108.010 and 108.013, and using the public
use data and other data, records, and matters of record available
to it, the council shall prepare and issue reports to the
governor, the legislature, and the public as provided by this
section and Section 108.006(a). The council must issue the
reports at least annually.
(c) Subject to the restrictions on access to council data
prescribed by Sections 108.010 and 108.013, the council shall use
public use data to prepare and issue reports that provide
information relating to providers, such as the incidence rate of
selected medical or surgical procedures. The reports must provide
the data in a manner that identifies individual providers,
including individual physicians, and that identifies and compares
data elements for all providers. Individual physicians may not
be identified by name, but shall be identified by uniform
physician identifiers. The council by rule shall designate the
characters to be used as uniform physician identifiers.
(d) The council shall adopt procedures to verify the accuracy
of the public use data before releasing the public use data to
the public.
(e) If public use data is requested from the council about a
specific provider, the council shall notify the provider about
the release of the data. This subsection does not authorize the
provider to interfere with the release of that data.
(f) A report issued by the council shall include a reasonable
review and comment period for the affected providers before
public release of the report.
(g) The council shall adopt rules allowing a provider to submit
concise written comments regarding any specific public use data
to be released concerning the provider. The council shall make
the comments available to the public and the office of the
council and in an electronic form accessible through the
Internet. The comments shall be attached to any public release
of the public use data. Providers shall submit the comments to
the council to be attached to the public release of public use
data in the same format as the public use data that is to be
released.
(h) Tapes containing public use data and provider quality
reports that are released to the public must include general
consumer education material, including an explanation of the
benefits and limitations of the information provided in the
public use data and provider quality reports.
(i) The council shall release public use data relating to
providers described by Section 108.0025(1), but that are not
rural providers because they do not meet the requirement of
Section 108.0025(2), in an aggregate form without uniform patient
and physician identifiers.
Added by Acts 1995, 74th Leg., ch. 726, Sec. 1, eff. Sept. 1,
1995. Amended by Acts 1997, 75th Leg., ch. 261, Sec. 11, eff.
Sept. 1, 1997.
Sec. 108.012. Computer Access to Data.
(a) The council shall provide a means for computer-to-computer
access to the public use data. All reports shall maintain
patient confidentiality as provided by Section 108.013.
(b) The council may charge a person requesting public use or
provider quality data a fee for the data. The fees may reflect
the quantity of information provided and the expense incurred by
the council in collecting and providing the data and shall be set
at a level that will raise revenue sufficient for the operation
of the council. The council may not charge a fee for providing
public use data to another state agency.
Added by Acts 1995, 74th Leg., ch. 726, Sec. 1, eff. Sept. 1,
1995. Amended by Acts 1997, 75th Leg., ch. 261, Sec. 11, eff.
Sept. 1, 1997.
Sec. 108.013. Confidentiality and General Access to Data.
(a) The data received by the council shall be used by the
council for the benefit of the public. Subject to specific
limitations established by this chapter and council rule, the
council shall make determinations on requests for information in
favor of access.
(b) The 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 council
may not release and a person or entity may not gain access to any
data:
(1) that could reasonably be expected to reveal the identity
of a patient or physician or that reveals the zip code of a
patient's primary residence;
(2) disclosing provider discounts or differentials between
payments and billed charges; or
(3) relating to actual payments to an identified provider
made by a payer.
(d) 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 5.08, Medical Practice Act (Article 4495b,
Vernon's Texas Civil Statutes).
(e) Data on patients and physicians and compilations produced
from the data collected that identify patients and physicians are
not:
(1) subject to discovery, subpoena, or other means of legal
compulsion for release to any person or entity except as
provided by this section; or
(2) admissible in any civil, administrative, or criminal
proceeding.
(f) Notwithstanding Subsection (c)(1), the council may use zip
code information to analyze data on a geographic basis.
(g) The council may not release data elements in a manner that
will reveal the identity of a physician or patient.
(h) Subsection (c)(1) and Subsection (g) do not prohibit the
release of a uniform physician identifier or a uniform patient
identifier in conjunction with associated public use data in
accordance with Section 108.011 or provider quality data in
accordance with Section 108.010.
(i) Notwithstanding any other law, the council and the
department may not provide information made confidential by this
section to any other agency of this state.
Added by Acts 1995, 74th Leg., ch. 726, Sec. 1, eff. Sept. 1,
1995. Amended by Acts 1997, 75th Leg., ch. 261, Sec. 12, eff.
Sept. 1, 1997.
Sec. 108.014. Civil Penalty.
(a) A person who knowingly or negligently releases data in
violation of this chapter is liable for a civil penalty of not
more than $10,000.
(b) A person who fails to supply available data under Sections
108.009 and 108.010 is liable for a civil penalty of not less
than $1,000 or more than $10,000 for each act of violation.
(c) The attorney general, at the request of the council, shall
enforce this chapter.
Added by Acts 1995, 74th Leg., ch. 726, Sec. 1, eff. Sept. 1,
1995.
Sec. 108.0141. Criminal Penalty.
(a) A person who with criminal negligence releases data in
violation of this chapter commits an offense.
(b) An offense under this section is a Class A misdemeanor.
Added by Acts 1997, 75th Leg., ch. 261, Sec. 13, eff. Sept. 1,
1997.
Sec. 108.015. Conflict of Interest.
The council may not accept a donation from a person required to
provide data under this chapter or from a person or business
entity who provides goods or services to the council for
compensation.
Added by Acts 1995, 74th Leg., ch. 726, Sec. 1, eff. Sept. 1,
1995