OCCUPATIONS CODE
CHAPTER 159. PHYSICIAN-PATIENT COMMUNICATION
§ 159.001. DEFINITIONS. In this chapter:
(1) "Billing record" means a record that describes
charges for services provided to a patient by a physician.
(2) "Medical record" does not include a billing
record.
(3) "Patient" means a person who, to receive medical
care, consults with or is seen by a physician.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 984, § 1, eff. June 15, 2001.
§ 159.002. CONFIDENTIAL COMMUNICATIONS. (a) A
communication between a physician and a patient, relative to or in
connection with any professional services as a physician to the
patient, is confidential and privileged and may not be disclosed
except as provided by this chapter.
(b) A record of the identity, diagnosis, evaluation, or
treatment of a patient by a physician that is created or maintained
by a physician is confidential and privileged and may not be
disclosed except as provided by this chapter.
(c) A person who receives information from a confidential
communication or record as described by this chapter, other than a
person listed in Section 159.004 who is acting on the patient's
behalf, may not disclose the information except to the extent that
disclosure is consistent with the authorized purposes for which the
information was first obtained.
(d) The prohibitions of this chapter continue to apply to a
confidential communication or record relating to a patient
regardless of when the patient receives the services of a
physician, except for medical records at least 100 years old that
are requested for historical research purposes.
(e) The privilege of confidentiality may be claimed by the
patient or by the physician. The physician may claim the privilege
of confidentiality only on behalf of the patient. The physician's
authority to claim the privilege is presumed in the absence of
evidence to the contrary.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 159.003. EXCEPTIONS TO CONFIDENTIALITY IN COURT OR
ADMINISTRATIVE PROCEEDINGS. (a) An exception to the privilege of
confidentiality in a court or administrative proceeding exists:
(1) in a proceeding brought by a patient against a
physician, including:
(A) a malpractice proceeding; or
(B) a criminal proceeding or license revocation
proceeding in which the patient is a complaining witness and
disclosure is relevant to a claim or defense of the physician;
(2) if the patient or a person authorized to act on the
patient's behalf submits a written consent to the release of
confidential information as provided by Section 159.005;
(3) in a proceeding to substantiate and collect on a
claim for medical services provided to the patient;
(4) in a civil action or administrative proceeding, if
relevant, brought by the patient or a person on the patient's
behalf, if the patient or person is attempting to recover monetary
damages for a physical or mental condition including the patient's
death;
(5) in a disciplinary investigation or proceeding
conducted under this subtitle, if the board protects the identity
of any patient whose billing or medical records are examined other
than a patient:
(A) for whom an exception exists under
Subdivision (1); or
(B) who has submitted written consent to the
release of the billing or medical records as provided by Section
159.005;
(6) in a criminal investigation of a physician in
which the board is participating, or assisting in the investigation
or proceeding by providing certain billing or medical records
obtained from the physician, if the board protects the identity of a
patient whose billing or medical records are provided in the
investigation or proceeding other than a patient:
(A) for whom an exception exists under
Subdivision (1); or
(B) who has submitted written consent to the
release of the billing or medical records as provided by Section
159.005;
(7) in an involuntary civil commitment proceeding,
proceeding for court-ordered treatment, or probable cause hearing
under Chapter 462, 574, or 593, Health and Safety Code;
(8) if the patient's physical or mental condition is
relevant to the execution of a will;
(9) if the information is relevant to a proceeding
brought under Section 159.009;
(10) in a criminal prosecution in which the patient is
a victim, witness, or defendant;
(11) to satisfy a request for billing or medical
records of a deceased or incompetent person under Section 4.01(e),
Medical Liability and Insurance Improvement Act of Texas (Article
4590i, Vernon's Texas Civil Statutes); or
(12) to a court or a party to an action under a court
order or court subpoena.
(b) This section does not authorize the release of
confidential information to investigate or substantiate criminal
charges against a patient.
(c) Records or communications are not discoverable under
Subsection (a)(10) until the court in which the prosecution is
pending makes an in camera determination as to the relevancy of the
records or communications or any portion of the records or
communications. That determination does not constitute a
determination as to the admissibility of the information.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 984, § 2, eff. June 15, 2001.
§ 159.004. EXCEPTIONS TO CONFIDENTIALITY IN OTHER
SITUATIONS. An exception to the privilege of confidentiality in a
situation other than a court or administrative proceeding, allowing
disclosure of confidential information by a physician, exists only
with respect to the following:
(1) a governmental agency, if the disclosure is
required or authorized by law;
(2) medical or law enforcement personnel, if the
physician determines that there is a probability of:
(A) imminent physical injury to the patient, the
physician, or another person; or
(B) immediate mental or emotional injury to the
patient;
(3) qualified personnel for research or for a
management audit, financial audit, or program evaluation, but the
personnel may not directly or indirectly identify a patient in any
report of the research, audit, or evaluation or otherwise disclose
identity in any manner;
(4) those parts of the medical records reflecting
specific services provided if necessary in the collection of fees
for medical services provided by a physician, professional
association, or other entity qualified to provide or arrange for
medical services;
(5) a person who has consent, as provided by Section
159.005;
(6) a person, corporation, or governmental agency
involved in the payment or collection of fees for medical services
provided by a physician;
(7) another physician or other personnel acting under
the direction of the physician who participate in the diagnosis,
evaluation, or treatment of the patient;
(8) an official legislative inquiry regarding state
hospitals or state schools, if:
(A) information or a record that identifies a
patient or client is not released for any purpose unless proper
consent to the release is given by the patient; and
(B) only records created by the state hospital or
school or its employees are included; or
(9) health care personnel of a penal or other
custodial institution in which the patient is detained if the
disclosure is for the sole purpose of providing health care to the
patient.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 984, § 3, eff. June 15, 2001.
§ 159.005. CONSENT FOR RELEASE OF CONFIDENTIAL
INFORMATION. (a) Consent for the release of confidential
information must be in writing and signed by:
(1) the patient;
(2) a parent or legal guardian of the patient if the
patient is a minor;
(3) a legal guardian of the patient if the patient has
been adjudicated incapacitated to manage the patient's personal
affairs;
(4) an attorney ad litem appointed for the patient, as
authorized by:
(A) Subtitle C, Title 7, Health and Safety Code;
(B) Subtitle D, Title 7, Health and Safety Code;
(C) Chapter XIII, Texas Probate Code; or
(D) Chapter 107, Family Code; or
(5) a personal representative of the patient if the
patient is deceased.
(b) The written consent must specify:
(1) the billing records, medical records, or other
information to be covered by the release;
(2) the reasons or purposes for the release; and
(3) the person to whom the information is to be
released.
(c) The patient, or other person authorized to consent, is
entitled to withdraw the consent to the release of any information.
Withdrawal of consent does not affect any information disclosed
before the written notice of the withdrawal.
(d) A patient may not bring an action against a physician
for a disclosure made by the physician in good faith reliance on an
authorized consent if the physician did not have written notice
that the authorization was revoked.
(e) A person who receives information made confidential by
this subtitle may disclose the information only to the extent
consistent with the authorized purposes for which consent to
release the information is obtained.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 984, § 4, eff. June 15, 2001.
§ 159.006. INFORMATION FURNISHED BY
PHYSICIAN. (a) Unless the physician determines that access to
the information would be harmful to the physical, mental, or
emotional health of the patient, a physician who receives a written
consent for release of information as provided by Section 159.005
shall furnish copies of the requested billing or medical records,
or a summary or narrative of the records, including records
received from a physician or other health care provider involved in
the care or treatment of the patient.
(b) The physician may delete confidential information about
another patient or a family member of the patient who has not
consented to the release.
(c) In accordance with Section 159.005, on receipt of a
written request by a subsequent or consulting physician of a
patient of the requested physician, the requested physician shall
furnish a copy of the complete billing or medical records of the
patient to the subsequent or consulting physician. The duty to
provide billing or medical records to a subsequent or consulting
physician may not be nullified by contract.
(d) A physician shall provide the information requested
under this section not later than the 15th business day after the
date of receipt of the written consent for release under Subsection
(a) or the written request under Subsection (c).
(e) If the physician denies the request, in whole or in
part, the physician shall:
(1) furnish the patient with a written statement,
signed and dated, providing the reason for the denial; and
(2) place a copy of the statement denying the request
in the patient's:
(A) billing records, if the request was for
billing records; or
(B) medical records, if the request was for
medical records.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 984, § 5, eff. June 15, 2001.
§ 159.0061. APPOINTMENT OF CUSTODIAN OF PHYSICIAN'S
RECORDS. (a) The board by rule shall establish conditions under
which the board may temporarily or permanently appoint a person as a
custodian of a physician's billing or medical records. In adopting
rules under this section, the board shall consider the death of a
physician, the mental or physical incapacitation of a physician,
and the abandonment of billing or medical records by a physician.
(b) The rules adopted under this section must provide for:
(1) the release of the billing or medical records by an
appointed custodian in compliance with this chapter; and
(2) a fee charged by the appointed custodian that is in
addition to the copying fee governed by Section 159.008.
Added by Acts 2001, 77th Leg., ch. 984, § 6, eff. June 15, 2001.
§ 159.007. MEDIUM BY WHICH INFORMATION IS PROVIDED. A
person who is authorized to provide a copy of a record or a summary
or narrative of the record to another person under this chapter may
provide the copy, summary, or narrative on paper or using any other
appropriate medium to which the person who is to provide and the
person who is to receive the copy, summary, or narrative agree.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 159.008. PHYSICIAN FEES FOR INFORMATION. (a) Except
as provided by Subsection (b), a physician:
(1) may charge a reasonable fee, as prescribed by
board rule, for copying billing or medical records; and
(2) is not required to permit examination or copying
of the records until the fee is paid unless there is a medical
emergency.
(b) A physician may not charge a fee for copying billing or
medical records under Subsection (a) to the extent the fee is
prohibited under Subchapter M, Chapter 161, Health and Safety Code.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 984, § 7, eff. June 15, 2001.
§ 159.009. INJUNCTION; CAUSE OF ACTION FOR UNAUTHORIZED
RELEASE OF CONFIDENTIAL INFORMATION. (a) A person aggrieved by a
violation of this chapter relating to the unauthorized release of
confidential and privileged communications may petition the
district court of the county in which the person resides, or in the
case of a nonresident of the state, the district court of Travis
County, for appropriate injunctive relief. The petition takes
precedence over all civil matters on the docketed court except
those matters to which equal precedence on the docket is granted by
law.
(b) The aggrieved person may prove a cause of action for
civil damages.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
