(a) The commission shall develop an electronic health information exchange system to improve the quality, safety, and efficiency of health care services provided under Medicaid and the child health plan program. In developing the system, the commission shall ensure that:
(1) the confidentiality of patients’ health information is protected and patient privacy is maintained in accordance with federal and state law, including:
(A) Section 1902(a)(7), Social Security Act (42 U.S.C. § 1396a(a)(7));
(B) the Health Insurance Portability and Accountability Act of 1996 (Pub. L. No. 104-191);
(C) Chapter 552;
(D) Subchapter G, Chapter 241, Health and Safety Code;
(E) § 12.003, Human Resources Code; and
(F) federal and state rules, including:
(i) 42 C.F.R. part 431, Subpart F; and
(ii) 45 C.F.R. part 164;
(2) appropriate information technology systems the commission and health and human services agencies use are interoperable;
(3) the system and external information technology systems are interoperable in receiving and exchanging appropriate electronic health information as necessary to enhance:
(A) the comprehensive nature of information contained in electronic health records; and
(B) health care provider efficiency by supporting integration of the information into the electronic health record health care providers use;
(4) the system and other health information systems not described by Subdivision (3) and data warehousing initiatives are interoperable; and
(5) the system includes the elements described by Subsection (b).
(b) The health information exchange system must include the following elements:
(1) an authentication process that uses multiple forms of identity verification before allowing access to information systems and data;
(2) a formal process for establishing data-sharing agreements within the community of participating providers in accordance with the Health Insurance Portability and Accountability Act of 1996 (Pub. L. No. 104-191) and the American Recovery and Reinvestment Act of 2009 (Pub. L. No. 111-5);
(3) a method by which the commission may open or restrict access to the system during a declared state emergency;
(4) the capability of appropriately and securely sharing health information with state and federal emergency responders;
(5) compatibility with the Nationwide Health Information Network (NHIN) and other national health information technology initiatives coordinated by the Office of the National Coordinator for Health Information Technology;
(6) technology that allows for patient identification across multiple systems; and
(7) the capability of allowing a health care provider with technology that meets current national standards to access the system.

(c) The health information exchange system must be developed in accordance with the Medicaid Information Technology Architecture (MITA) initiative of the Centers for Medicare and Medicaid Services and conform to other standards required under federal law.

Text of section effective on April 01, 2025