HBA-NMO H.B. 2633 76(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 2633 By: Gray Public Health 4/5/1999 Introduced BACKGROUND AND PURPOSE Current law provides for the confidentiality of medical patient records, but does not extend the same protection to dental patient records. H.B. 2633 provides for the confidentiality of dental patient records, with certain exceptions. 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 Chapter 9, Title 71, V.T.C.S. (Dental Practice Act), by adding Article 4549-3 to read as follows: ARTICLE 4549-3. CONFIDENTIALITY OF DENTAL PATIENT RECORDS Sec. 1. DEFINITION. Defines "dental record" as any record relating to the history, diagnosis, treatment, or prognosis of a dental patient. Sec. 2. SCOPE OF PRIVILEGE. (a) Provides that a communication that relates to or is in connection with professional services rendered as a dentist, between a dentist and a patient, is confidential and privileged and prohibits it from being disclosed, except as provided by this article. (b) Provides that records of the identity, diagnosis, evaluation, or treatment of a patient by a dentist that are created or maintained by a dentist are confidential and privileged and prohibits them from being disclosed, except as provided by this article. (c) Prohibits a person who receives information from confidential communications or dental records, other than a person listed under Section 5 or 6 of this article who is acting on a patient's behalf, from disclosing the information except to the extent that disclosure is consistent with the authorized purposes for which the information was first obtained. (d) Provides that the prohibitions of this section continue to apply to confidential communications or records concerning a patient irrespective of when the patient received the services of a dentist. Sec. 3. CLAIM OF PRIVILEGE. Authorizes claim of the privilege of confidentiality under this article by the patient or by a dentist acting on the patient's behalf. Authorizes a dentist to claim the privilege of confidentiality only on behalf of the patient. Provides that the authority to claim the privilege is presumed in the absence of evidence to the contrary. Sec. 4. EXCEPTIONS. Provides that an exception to the confidentiality and privilege requirements under this article exists in certain respective conditions in a court or administrative proceeding; a civil litigation or administrative proceeding; a disciplinary investigation or proceeding against a dentist; criminal investigation of or criminal proceeding against a dentist; and a criminal prosecution in which the patient is a victim, witness, or defendant. Sec. 5. DISCLOSURE OF OTHERWISE CONFIDENTIAL INFORMATION. (a) Provides that an exception to the confidentiality or privilege requirements of this article exists only for, and authorizes a dentist, in circumstance other than those described by Section 4, to disclose confidential information only to a governmental agency, under certain circumstances; medical or law enforcement personnel, under certain circumstances; qualified personnel for the purpose of management audits, financial audits, program evaluations, or research; a person who presents the written consent of the patient or another person authorized to act on the patient's behalf for the release of confidential information, as provided by Section 6 of this article; an individual, corporation, or governmental entity involved in the payment or collection of fees for services rendered by a dentist; or another dentist and persons under the direction of the dentist who are participating in the diagnosis, evaluation, or treatment of the patient. (b) Prohibits qualified personnel who for receive information the purpose of management audits, financial audits, program evaluations, or research from identifying a patient, directly or indirectly, in any report of the research, audit, or evaluation or otherwise disclose a patient's identity. (c) Authorizes the disclosure of records reflecting charges and specific services rendered only when necessary in the collection of fees for services provided by a dentist, professional association, or other entity qualified to render or arrange for services. (d) Authorizes the disclosure of information otherwise confidential under this article in an official legislative inquiry regarding a state hospital or state school. Prohibits, however, the release of information or records that identify a patient or client for any purposes unless the patient gives proper consent to the release. Provides that this subsection applies only to records created by the state hospital, state school, or an employee of the state hospital or state school. Sec. 6. CONSENT. (a) Provides that consent for the release of confidential information must be made in writing and signed by the patient, a parent or legal guardian if the patient is a minor; a legal guardian if the patient has been adjudicated incompetent to manage the patient's personal affairs; an attorney ad litem appointed for the patient, or a personal representative if the patient is deceased. (b) The written consent required under this section must specify the information and records to be covered by the release, the reasons or purposes for the release; and the person to whom the information is to be released. (c) Provides that the patient or other person authorized to consent has the right to withdraw the consent to the release of any information. Provides that withdrawal of consent does not affect information disclosed before the written notice of the withdrawal. Sec. 7. FURNISHING INFORMATION. Authorizes a person who receives information made confidential by this article to disclose the information to others only to the extent consistent with the authorized purposes for which consent to release the information was obtained. Sec. 8. SUBSEQUENT DISCLOSURE. Requires a dentist to furnish copies of dental records requested or a summary or narrative of the records under a written consent for release of the information as provided by Section 6 of this article unless the dentist determines that access to the information would be harmful to the physical, mental, or emotional health of the patient. Authorizes the dentist to delete confidential information about another person who has not consented to the release. Requires that the information be furnished by the dentist within a reasonable period of time, and requires that reasonable fees for furnishing the information be paid by the patient or another person acting on the patient's behalf. Sec. 9. Emergency clause. Effective date: upon passage.