HBA-NMO C.S.H.B. 2171 76(R)BILL ANALYSIS Office of House Bill AnalysisC.S.H.B. 2171 By: Luna, Vilma Public Health 4/11/1999 Committee Report (Substituted) BACKGROUND AND PURPOSE Current law authorizes 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 does not grant this same authority to a hospital district that has 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 authorizes it to evaluate medical and heath-care services through a medical peer review committee or a medical committee. C.S.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 in the definition of "health care entity." 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, appointed by 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 committee or a meeting of the governing body of a public hospital, hospital district, or hospital authority at which the governing body receives records or reports provided by a medical committee is not subject to Chapter 551 (Open Meetings), Government Code. Provides that records of a medical committee and records or reports of a medical committee to the governing body of a public hospital, hospital district, or hospital authority are not subject to disclosure under Chapter 552 (Pubic Information), Government Code. 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. MEDICAL COMMITTEES AND MEDICAL PEER REVIEW COMMITTEES Deletes "Records of and Immunities for" and adds "and Medical Peer Review Committees" to the title. 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. 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. SECTION 7.Emergency clause. Effective date: upon passage. COMPARISON OF ORIGINAL TO SUBSTITUTE The substitute differs from the original in the caption. The substitute differs from the original in SECTION 1, in the amendment of Section 1.03(a)(5), Article 4495b, V.T.C.S., by including a hospital authority, in addition to a hospital district, as proposed, in a list of entities within the definition of "health care entity." The substitute differs from the original in SECTION 2, in proposed Section 5.06(v), Article 4495b, V.T.C.S., by providing that this section (Reporting and Confidentiality Requirements) does not impose liability or waive immunity for a hospital authority, in addition to a hospital district, as proposed, that has common law, statutory, or other immunity. The substitute differs from the original in SECTION 3, in the amendment of Section 161.031(a), Health and Safety Code, by removing any entity designated or contracted to act as a medical committee by certain health care entities from the definition of "medical committee." Differs by including in the definition of "medical committee" a committee, including a joint committee, of a hospital authority, in addition to a hospital district, as proposed. The substitute differs from the original in SECTION 4, in the amendment of Section 161.032(a), Health and Safety Code, by providing that a meeting of the governing body of a public hospital, hospital district, or hospital authority at which the governing body receives records or reports provided by a medical committee, in addition to a proceeding of a medical committee, as proposed, is not subject to Chapter 551 (Open Meetings), Government Code. Differs by providing that records or reports of a medical committee to the governing body of a public hospital, hospital district, or hospital authority, in addition to records of a medical committee, as proposed, are not subject to disclosure under Chapter 552 (Pubic Information), Government Code. Differs by making nonsubstantive changes. Differs in the amendment of Section 161.032(c), by including a hospital authority, in addition to a hospital district, as proposed, in 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. The substitute differs from the original in SECTION 5 by amending the heading of Subchapter D, Chapter 161, Health and Safety Code, rather than amending Chapter 285, Health and Safety Code, by adding Subchapter K (Committees to Evaluate Medical and Health-Care Services), as proposed. The substitute differs from the original in SECTION 6 by adding Section 161.0315 (Authority of Governing Body to Form Committee to Evaluate Medical and Health Care Services), Health and Safety Code. This section essentially modifies the language of proposed Section 285.141, Health and Safety Code (SECTION 5 of the original), by authorizing the governing body of a hospital, medical organization, university medical school or health science center, health maintenance organization, extended care facility, or hospital authority, in addition to a hospital district, as proposed, to form a medical peer review committee or a medical committee to evaluate medical and health-care services. SECTION 7 (emergency clause) of the substitute is redesignated from SECTION 6 of the original.