CHAPTER 159. PHYSICIAN-PATIENT COMMUNICATION
OCCUPATIONS CODE
TITLE 3. HEALTH PROFESSIONS
SUBTITLE B. PHYSICIANS
CHAPTER 159. PHYSICIAN-PATIENT COMMUNICATION
Sec. 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, Sec. 1, eff. Sept. 1, 1999.
Amended by Acts 2001, 77th Leg., ch. 984, Sec. 1, eff. June 15,
2001.
Sec. 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, Sec. 1, eff. Sept. 1, 1999.
Sec. 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 74.051(e), Civil
Practice and Remedies Code; 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, Sec. 1, eff. Sept. 1, 1999.
Amended by Acts 2001, 77th Leg., ch. 984, Sec. 2, eff. June 15,
2001.
Amended by:
Acts 2005, 79th Leg., Ch.
139, Sec. 1, eff. September 1, 2005.
Sec. 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, Sec. 1, eff. Sept. 1, 1999.
Amended by Acts 2001, 77th Leg., ch. 984, Sec. 3, eff. June 15,
2001.
Sec. 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, Sec. 1, eff. Sept. 1, 1999.
Amended by Acts 2001, 77th Leg., ch. 984, Sec. 4, eff. June 15,
2001.
Sec. 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, Sec. 1, eff. Sept. 1, 1999.
Amended by Acts 2001, 77th Leg., ch. 984, Sec. 5, eff. June 15,
2001.
Sec. 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, Sec. 6, eff. June 15,
2001.
Sec. 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, Sec. 1, eff. Sept. 1, 1999.
Sec. 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, Sec. 1, eff. Sept. 1, 1999.
Amended by Acts 2001, 77th Leg., ch. 984, Sec. 7, eff. June 15,
2001.
Sec. 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, Sec. 1, eff. Sept. 1, 1999.
Sec. 159.010. NOTICE OF BENEFITS UNDER STATE CHILD HEALTH PLAN.
A physician who provides Medicaid health care services to a
pregnant woman shall inform the woman of the health benefits for
which the woman or the woman's child may be eligible under the
state child health plan under Chapter 62, Health and Safety Code.
Added by Acts 2005, 79th Leg., Ch.
349, Sec. 24, eff. September 1, 2005.