HBA-MPM, NMO H.B. 2171 76(R)BILL ANALYSIS Office of House Bill AnalysisH.B. 2171 By: Luna, Vilma Public Health 7/19/1999 Enrolled BACKGROUND AND PURPOSE Prior to the 76th Legislature, state law authorized certain health care entities to form a medical peer review committee or a medical committee to evaluate the medical or health-care services provided by each respective entity. However, the law did not grant this same authority to a hospital district that had contracted out its medical or health care services. In 1996, the Nueces County Hospital District leased its hospital and three clinics to Spohn Health System, a local Catholic healthcare system. The hospital district separately contracted with the Spohn System to furnish medical aid and hospital care to indigent and needy persons within the hospital district's boundaries. As a result of the hospital district leasing its hospital, the law no longer authorized it to evaluate medical and heath-care services through a medical peer review committee or a medical committee. H.B. 2171 authorizes the governing body of a hospital, medical organization, university medical school or health science center, health maintenance organization, extended care facility, hospital district, or hospital authority to form a medical peer review committee or a medical committee to evaluate medical and health-care services provided or paid for by the entity. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that this bill does not expressly delegate any additional rulemaking authority to a state officer, department, agency, or institution. SECTION BY SECTION ANALYSIS SECTION 1. Amends Section 1.03(a)(5), Article 4495b, V.T.C.S. (Medical Practice Act), to include in the definition of "health care entity"certain entities that pay for, in addition to provide, medical or health-care services and that follow a formal peer review process. Adds a hospital district and a hospital authority to that list of entities. Makes conforming changes relating to codification. SECTION 2. Amends Section 5.06, Article 4495b, V.T.C.S. (Medical Practice Act), by adding Subsection (v), as follows: (v) Provides that this section (Reporting and Confidentiality Requirements) does not impose liability or waive immunity for a hospital district or hospital authority that has common-law, statutory, or other immunity. SECTION 3. Amends Section 161.031(a), Health and Safety Code, to include in the definition of "medical committee" a committee, including a joint committee, of a hospital district or hospital authority. SECTION 4. Amends Sections 161.032(a) and (c), Health and Safety Code, to provide that a proceeding of a medical peer review committee, as defined by Section 1.03 (Definitions), Article 4495b, V.T.C.S. (Medical Practice Act), or medical committee, or a meeting of the governing body of a public hospital, hospital district, or hospital authority at which the governing body receives records, information, or reports provided by a medical committee or medical peer review committee is not subject to Chapter 551 (Open Meetings), Government Code. Makes the following not subject to disclosure under Chapter 552 (Public Information), Government Code: records, information, or reports of a medical committee or medical peer review committee, and records, information, or reports provided by a medical committee or medical peer review committee to the governing body of a public hospital, hospital district, or hospital authority. Adds a hospital district and a hospital authority to the list of entities to whose records maintained in the regular course of business this section (Records and Proceedings Confidential) and Section 5.06 (Reporting and Confidentiality Requirements), Article 4495b, V.T.C.S. (Medical Practice Act), do not apply. SECTION 5. Amends the heading of Subchapter D, Chapter 161, Health and Safety Code, as follows: SUBCHAPTER D. New heading: MEDICAL COMMITTEES AND MEDICAL PEER REVIEW COMMITTEES Deletes "Records of and Immunities for" and adds "and Medical Peer Review Committees" to the heading. SECTION 6. Amends Subchapter D, Chapter 161, Health and Safety Code, by adding Section 161.0315, as follows: Sec. 161.0315. AUTHORITY OF GOVERNING BODY TO FORM COMMITTEE TO EVALUATE MEDICAL AND HEALTH-CARE SERVICES. (a) Authorizes the governing body of a hospital, medical organization, university medical school or health science center, health maintenance organization, extended care facility, hospital district, or hospital authority to form a medical peer review committee or a medical committee to evaluate medical and health care services, except as provided by this section. (b) Prohibits a medical peer review committee or medical committee formed by the governing body of a hospital district from evaluating medical and health care services provided by a health care facility that contracts with the district to provide those services and has formed a medical peer review committee or medical committee to evaluate the facility's services, except as provided by Subsection (d). (c) Authorizes a hospital district to require in a contract with a health care facility described by Subsection (b) a provision allowing the district's governing body to appoint a specified number of members to the facility's medical peer review committee or medical committee to evaluate medical and health care services for which the district contracts with the facility to provide. Authorizes the governing body of a hospital district to review a report from a facility's medical peer review committee or medical committee under this section in a closed meeting. Provides that a report, information, or record the district receives that is related to a review action conducted under contract terms is subject to certain confidentiality and disclosure requirements. (d) Provides that if a hospital district and health care facility described by Subsection (b) do not agree on a contract provision described by Subsection (c), the district has, with respect to a review action for the evaluation of medical and health care services provided by the facility under a contract with the district, a right to take certain actions with respect to the review action. (e) Authorizes the governing body of a hospital district to receive a report under Subsection (d) in a closed meeting. Provides that this report, information, or a record the district receives under Subsection (d) is subject to certain confidentiality and disclosure requirements. SECTION 7.Emergency clause. Effective date: upon passage.