Texas Statutes
Subchapter F. Duties Relating to Health Maintenance Organizations
Section 501.254. Confidentiality and Use of Information

Sec. 501.254. CONFIDENTIALITY AND USE OF INFORMATION. (a) Except as provided by this section, information collected under this subchapter is subject to Chapter 552, Government Code, and the office shall make determinations on requests for information in favor of access.
(b) The office may not make public any confidential information provided to the office under this subchapter but may disclose a summary of the information that does not directly or indirectly identify the health maintenance organization that is the subject of the information. The office may not release, and a person or entity may not gain access to, any information that:
(1) could reasonably be expected to reveal the identity of a patient or physician;
(2) reveals the zip code of a patient's primary residence;
(3) discloses a provider discount or a differential between a payment and a billed charge; or
(4) relates to an actual payment made by a payer to an identified provider.
(c) Information collected or used by the office under this subchapter is subject to the confidentiality provisions and criminal penalties of:
(1) Section 81.103, Health and Safety Code;
(2) Section 311.037, Health and Safety Code; and
(3) Chapter 159, Occupations Code.
(d) Information on patients and physicians that is in the possession of the office and any compilation, report, or analysis produced from the information that identifies patients and physicians is not:
(1) subject to discovery, subpoena, or other means of legal compulsion for release to any person or entity; or
(2) admissible in any civil, administrative, or criminal proceeding.
(e) Notwithstanding Subsection (b)(2), the office may use zip code information to analyze information on a geographical basis.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 2, eff. April 1, 2005.

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