CHAPTER 159. PHYSICIAN-PATIENT COMMUNICATION

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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.

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.

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;

(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.

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.

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.

State Codes and Statutes

State Codes and Statutes

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State Codes and Statutes

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