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A BILL TO BE ENTITLED
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AN ACT
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relating to the confidentiality of certain information following |
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the completion of a review conducted by a utilization review agent |
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or an independent review organization. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1305.355, Insurance Code, is amended by |
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adding Subsection (h) to read as follows: |
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(h) Notwithstanding Section 4202.009(a), following the |
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completion of an independent review requested under Subsection (a), |
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on written request to the independent review organization, a party |
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to the reviewed medical dispute is entitled to the name and |
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professional qualifications of any doctor or other health care |
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practitioner used to perform the independent review. |
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SECTION 2. Section 4201.557, Insurance Code, is amended to |
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read as follows: |
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Sec. 4201.557. REQUIREMENT TO MAINTAIN DATA IN CONFIDENTIAL |
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MANNER. (a) Except as provided by Subsection (b), a [A] |
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utilization review agent shall maintain all data concerning a |
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patient or physician or other health care provider in a |
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confidential manner that prevents unauthorized disclosure to a |
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third party. |
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(b) Following the completion of a utilization review |
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determination, on written request to the utilization review agent, |
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a patient, or a patient's representative, is entitled to the name |
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and professional qualifications of any physician or other |
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individual health care provider who made the utilization review |
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determination. |
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SECTION 3. Section 4202.009, Insurance Code, is amended to |
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read as follows: |
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Sec. 4202.009. CONFIDENTIAL INFORMATION. (a) Except as |
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provided by Subsection (b), information [Information] that reveals |
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the identity of a physician or other individual health care |
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provider who makes a review determination for an independent review |
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organization is confidential. |
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(b) Following the completion of an independent review |
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determination, on written request to the independent review |
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organization, a patient, as defined by Section 4201.002, or the |
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patient's representative, is entitled to the name and professional |
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qualifications of any physician or other individual health care |
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provider who made the independent review determination. |
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SECTION 4. The change in law made by this Act applies only |
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to a determination made by a utilization review agent or an |
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independent review organization with reference to a review that was |
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requested on or after the effective date of this Act. A |
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determination made by a utilization review agent or an independent |
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review organization with reference to a review that was requested |
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before the effective date of this Act is governed by the law in |
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effect immediately before the effective date of this Act, and that |
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law is continued in effect for that purpose. |
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SECTION 5. This Act takes effect September 1, 2015. |