ADOPTED RULES An agency may take final action on a section 30 days after a proposal has been published in the Texas Register. The section becomes effective 20 days after the agency files the correct document with the Texas Register, unless a later date is specified or unless a federal statute or regulation requires implementation of the action on shorter notice. If an agency adopts the section without any changes to the proposed text, only the preamble of the notice and statement of legal authority will be published. If an agency adopts the section with changes to the proposed text, the proposal will be republished with the changes. TITLE 7. BANKING AND SECURITIES PART VII. State Securities Board CHAPTER 105.Rules of Practice in Contested Cases 7 TAC sec.105.22, sec.105.23 The State Securities Board adopts new rules sec.105.22 and sec.105.23, concerning contested cases. Section 105.23 is adopted with changes to the proposed text as published in the April 1, 1997, issue of the Texas Register (22 TexReg 3184). The word "individually" was added in sec.105.23(b) to clarify that an individual Board member may communicate ex parte with members of the Agency who did not participate in the contested case hearing. Section 105.22 is adopted without changes and will not be republished. The rules allow the Board to act in place of the Securities Commissioner in contested case decisions when the Board deems it appropriate to do so. Such intervention is entirely within the discretion of the Board, and the Board cannot be compelled to do so. The rules also extend to Board members existing Agency practice regarding ex parte communications. The rules provide a mechanism for the Board to intervene in contested case decisions at the Board's option and detail ex parte communication policies to be followed by the Securities Commissioner, Board, or other decision maker during contested case proceedings. One comment letter was received regarding adoption of the new rules. That letter, from Kuperman, Orr, Mouer & Albers, supported adoption of the new rules. The Board agreed and adopted the rules substantially as published. The new rules are adopted under Texas Civil Statutes, Article 581-28-1. Section 28-1 provides the Board with the authority to adopt rules and regulations necessary to carry out and implement the provisions of the Texas Securities Act, including rules and regulations governing registration statements and applications; defining terms; classifying securities, persons, and matters within its jurisdiction; and prescribing different requirements for different classes. sec.105.23.Ex Parte Communications. (a) Upon the issuance of a Notice of Hearing in a contested case and continuing until a Motion for Rehearing is ruled on or the time for ruling on such a Motion has expired, the Securities Commissioner (or other person assigned to render a decision in a contested case) and members of the Board may not communicate directly or indirectly with any party or a representative of a party in a contested case in connection with any issue of fact or law in the proceeding except on notice and opportunity for all parties to participate. (b) The Securities Commissioner (or other person assigned to render a decision in a contested case) and members of the Board, individually, may communicate ex parte with employees of the Agency who did not participate in any hearing in the case in order to utilize special skills or knowledge of the Agency's staff in evaluating the record in the case. Prohibited ex parte communications shall not include any written communication if the communicator contemporaneously serves copies of the communication on all parties to the proceeding. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on August 1, 1997. TRD-9709983 Denise Voigt Crawford Securities Commissioner State Securities Board Effective date: August 21, 1997 Proposal publication date: April 1, 1997 For further information, please call: (512) 305-8300 CHAPTER 107.Terminology SUBCHAPTER 7 TAC sec.107.2 The State Securities Board adopts an amendment to sec.107.2, concerning definitions, with changes to the proposed text as published in the April 18, 1997, issue of the Texas Register (22 TexReg 3567). The word "investment" was inserted before "adviser," in the definition of "solicitor," to clarify that the definition applies to a person or entity functioning as a solicitor for an investment adviser. The rule formalizes an existing agency policy requiring registration by a person or entity receiving compensation for soliciting clients for an investment adviser. The rule identifies persons and entities, compensated for soliciting clients on behalf of an investment adviser, required to be registered as an agent of an investment adviser. One comment letter was received on the proposal. The letter, from Kuperman, Orr, Mouer & Albers ("KOMA"), opposed adoption of the rule and commented: that defining the term "solicitor" serves no purpose; that requiring registration of a person who solicits clients for an investment adviser adds a "new" layer of unnecessary regulatory burden and cost; and that the Securities and Exchange Commission ("SEC") has not required such persons to register. In that letter, KOMA also noted that the investment adviser's client would receive appropriate disclosures (of the solicitor's compensation arrangement with the investment adviser) under current Board rules and stated that the SEC does not require registration of solicitors. The Board disagreed and adopted the definition substantially as proposed. In the open meeting, the Staff of the State Securities Board explained that established agency practice has been to consider a person or entity, compensated for soliciting clients for a dealer or investment adviser, as a "link in the chain" of sale of a security or in the rendering of investment advice. A person or entity engaging in such an activity would be operating as an "agent," as defined in sec.4.D of the Texas Securities Act, and is required to be registered as such. Registration of solicitors as "agents" has long been required by the agency and is documented in the investment adviser registration package provided by staff to new applicants. Adding the proposed definition for "solicitor" would provide clear guidance on this practice to industry and practitioners. Other Board rules provide an exclusion from the registration requirements for certain types of professionals who refer clients to an investment adviser when such a referral is solely incidental to the professional's practice of his or her profession. Likewise, a person would not fall within the parameters of the proposed definition of a solicitor unless the person was compensated for the referral. The SEC does require firms that solicit for multiple investment advisers to be registered. The agency's current position, requiring registration of a person or entity compensated for soliciting clients for an investment adviser, is consistent with the SEC position and the agency's treatment of parties performing a similar function on behalf of dealers. The amendment is adopted under Texas Civil Statutes, Article 581-28-1. Section 28-1 provides the Board with the authority to adopt rules and regulations necessary to carry out and implement the provisions of the Texas Securities Act, including rules and regulations governing registration statements and applications; defining terms; classifying securities, persons, and matters within its jurisdiction; and prescribing different requirements for different classes. sec.107.2.Definitions. The following words and terms, when used in Part VII of this title (relating to the State Securities Board), shall have the following meanings, unless the context clearly indicates otherwise. Solicitor - Any person or entity who, for compensation, acts as an agent of an investment adviser in referring potential clients. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on August 1, 1997. TRD-9709984 Denise Voigt Crawford Securities Commissioner State Securities Board Effective date: August 21, 1997 Proposal publication date: April 18, 1997 For further information, please call: (512) 305-8300 CHAPTER 111.Securities Exempt from Registration 7 TAC sec.111.2 The State Securities Board adopts an amendment to sec.111.2, concerning listed and designated securities, with changes to the proposed text as published in the April 1, 1997, issue of the Texas Register (22 TexReg 3186). A comma was added after "dealer" in subsection (c). The amendment modernizes the rule by updating terminology to current usage and conforming the format to current standards. The rule notes that the Midwest Stock Exchange has been renamed the Chicago Stock Exchange and utilizes updated terminology. One comment letter was received regarding the amendment. That letter, from Kuperman, Orr, Mouer & Albers, supported adoption of the amendment. The Board agreed and adopted the rule as published. The amendment is adopted under Texas Civil Statutes, Article 581-28-1. Section 28-1 provides the Board with the authority to adopt rules and regulations necessary to carry out and implement the provisions of the Texas Securities Act, including rules and regulations governing registration statements and applications; defining terms; classifying securities, persons, and matters within its jurisdiction; and prescribing different requirements for different classes. sec.111.2.Listed and Designated Securities. (a) Fully listed. As used in the Texas Securities Act, sec.6.F, "fully listed" includes any security listed or approved for listing upon notice of issuance on an exchange specified in the Act, sec.6.F, or on an exchange listed in subsection (b) of this section. The Midwest Stock Exchange, referenced in the Act, sec.6.F, has been renamed the Chicago Stock Exchange; thus, securities which at the time of sale have been fully listed upon the Chicago Stock Exchange fall within the exemption provided in the Act, sec.6.F. (b) Approved exchanges. The Securities Commissioner has approved the following exchanges, by written order, as satisfying the requirements of the Texas Securities Act, sec.6.F, for eligibility: (1) Pacific Stock Exchange; (2) Chicago Board Options Exchange. (c) Warrants for listed securities. In addition to sales made under the Texas Securities Act, sec.6.F, the Board, pursuant to the Act, sec.5.T, exempts from the registration requirements of the Act, sec.7, the offer and sale by the issuer itself, or by a registered dealer, of warrants to purchase securities of the issuer which at the time of sale of the warrants are exempt pursuant to the Act, sec.6.F. (d) Recognized and responsible stock exchange. In order to implement the general purposes of the Texas Securities Act declared in sec.10-1.A to maximize coordination with federal and other states law and administration, particularly with respect to exemptions, the Board hereby defines the term "recognized and responsible stock exchange," as used in the Act, sec.6.F, not to include any organization which is not registered with the United States Securities and Exchange Commission as a national securities exchange pursuant to the Securities Exchange Act of 1934, sec.6. (e) Who may sell. Securities described in the Act, sec.6.F, may be sold by or through a registered securities dealer acting either as a principal or agent. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on August 1, 1997. TRD-9709985 Denise Voigt Crawford Securities Commissioner State Securities Board Effective date: August 21, 1997 Proposal publication date: April 1, 1997 For further information, please call: (512) 305-8300 CHAPTER 133.Forms 7 TAC sec.sec.133.15, 133.17, 133.19, 133.20, 133.24, 133.25 The State Securities Board adopts the repeal of six forms concerning dealer registration. Specifically, the forms repealed are: sec.133.15, the form for Application for Registration as an Individual Securities Dealer or Investment Adviser; sec.133.17, the form for Multiple Registration-Undertaking to Disclose Affiliations; sec.133.19, the form for Application for Registration of a Corporation or Partnership as a Securities Dealer or Investment Adviser; sec.133.20, the form for Application for Registration of an Officer or Partner; sec.133.24, the form for Application for Registration as a Securities Salesman or Agent; and sec.133.25, the form for Application for Transfer of Securities Salesman's Registration. The repeals are adopted without changes to the proposed text as published in the April 1, 1997, issue of the Texas Register (22 TexReg 3186). The repeals eliminate unique Texas forms. Section 133.33 allows the use of uniform forms ADV, BD, and U-4 in lieu of the repealed forms. The requirements in sec.133.17 are covered by another rule in Chapter 115. The repeals eliminate unnecessary forms. No comments were received regarding adoption of the repeals. The repeals are adopted under Texas Civil Statutes, Article 581-28-1. Section 28-1 provides the Board with the authority to adopt rules and regulations necessary to carry out and implement the provisions of the Texas Securities Act, including rules and regulations governing registration statements and applications; defining terms; classifying securities, persons, and matters within its jurisdiction; and prescribing different requirements for different classes. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on August 1, 1997. TRD-9709986 Denise Voigt Crawford Securities Commissioner State Securities Board Effective date: August 21, 1997 Proposal publication date: April 1, 1997 For further information, please call: (512) 305-8300 TITLE 22. EXAMINING BOARDS PART XXII. Texas State Board of Public Accountancy CHAPTER 511.Certification as a CPA Educational Requirements 22 TAC sec.511.57 The Texas State Board of Public Accountancy adopts an amendment sec.511.57, without changes to the proposed text as published in the June 20, 1997, issue of the Texas Register, (22 TexReg 5884). The amendment allows the Board to recognize accounting courses which are accepted by educational institutions toward a baccalaureate degree or its equivalent. The amendment will function by easing the restrictions on accounting courses which are acceptable to the Board. No comments were received concerning adoption of the rule. The rule is adopted under Texas Civil Statutes, Article 41a-1, sec.6, which provides the Texas State Board of Public Accountancy with the authority to make such rules as may be necessary or advisable to carry in effect the purposes of the law; and sec.12 which authorizes the Board to issue rules regarding undergraduate courses. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on July 24, 1997. TRD-9710013 William Treacy Executive Director Texas State Board of Public Accountancy Effective date: August 21, 1997 Proposal publication date: June 20, 1997 For further information, please call: (512) 505-5566 22 TAC sec.511.58 The Texas State Board of Public Accountancy adopts an amendment sec.511.58, without changes to the proposed text as published in the June 20, 1997, issue of the Texas Register, (22 TexReg 5884). The amendment creates a pool of applicants who completed courses the board considers necessary for a well-rounded CPA education. The amendment will function by allowing the board to limit to 20 hours the number of hours of related business subjects the board will accept but expands the definition to also include those courses which the educational institution would accept. No comments were received concerning adoption of the rule. The rule is adopted under Texas Civil Statutes, Article 41a-1, sec.6, which provides the Texas State Board of Public Accountancy with the authority to make such rules as may be necessary or advisable to carry in effect the purposes of the law, and sec.12 which authorizes the board to issue rules regarding under- graduate courses. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on July 24, 1997. TRD-9710014 William Treacy Executive Director Texas State Board of Public Accountancy Effective date: August 21, 1997 Proposal publication date: June 20, 1997 For further information, please call: (512) 505-5566 CPA Examination 22 TAC sec.511.60 The Texas State Board of Public Accountancy adopts an amendment sec.511.60, without changes to the proposed text as published in the June 20, 1997, issue of the Texas Register, (22 TexReg 5885). The amendment allows the rule to use the correct name of the examination. The amendment will function by changing the name of the examination to agree with the actual name of the current examination. No comments were received concerning adoption of the rule. The rule is adopted under Texas Civil Statutes, Article 41a-1, sec.6, which provides the Texas State Board of Public Accountancy with the authority to make such rules as may be necessary or advisable to carry in effect the purposes of the law. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on July 24, 1997. TRD-9710015 William Treacy Executive Director Texas State Board of Public Accountancy Effective date: August 21, 1997 Proposal publication date: June 20, 1997 For further information, please call: (512) 505-5566 22 TAC sec.511.73 The Texas State Board of Public Accountancy adopts an amendment to sec.511.73, without changes to the proposed text as published in the June 20, 1997, issue of the Texas Register, (22 TexReg 5885). The amendment allows the rule to use the correct name of the examination. The amendment will function by changing the name of the examination to agree with the actual name of the current examination. No comments were received concerning adoption of the rule. The rule is adopted under Texas Civil Statutes, Article 41a-1, sec.6, which provides the Texas State Board of Public Accountancy with the authority to make such rules as may be necessary or advisable to carry in effect the purposes of the law. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on July 24, 1997. TRD-9710016 William Treacy Executive Director Texas State Board of Public Accountancy Effective date: August 21, 1997 Proposal publication date: June 20, 1997 For further information, please call: (512) 505-5566 Certification 22 TAC sec.511.173 The Texas State Board of Public Accountancy adopts new sec.511.173, without changes to the proposed text as published in the June 20, 1997, issue of the Texas Register, (22 TexReg 5886). The new rule allows the board to receive complaints or initiate investigations and to conduct hearings regarding eligibility of a candidate for a certificate based upon certain occurrences including the ones listed in this section. The new rule will function by enabling the board to perform investigations and conduct hearings regarding the eligibility of a candidate for a certificate. No comments were received concerning adoption of the rule. The rule is adopted under Texas Civil Statutes, Article 41a-1, sec.6, which provides the Texas State Board of Public Accountancy with the authority to make such rules as may be necessary or advisable to carry in effect the purposes of the law; and sec.12 which requires the board to ensure that applicants satisfy a moral character review. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on July 24, 1997. TRD-9710017 William Treacy Executive Director Texas State Board of Public Accountancy Effective date: August 21, 1997 Proposal publication date: June 20, 1997 For further information, please call: (512) 505-5566 22 TAC sec.511.174 The Texas State Board of Public Accountancy adopts new sec.511.174, without changes to the proposed text as published in the June 20, 1997, issue of the Texas Register, (22 TexReg 5886). The new rule allows the board the ability to screen and exclude ineligible CPA applicants. The new rule will function by listing the possible resolutions of an eligibility hearing and by describing the post-hearing procedure. No comments were received concerning adoption of the rule. The rule is adopted under Texas Civil Statutes, Article 41a-1, sec.6, which provides the Texas State Board of Public Accountancy with the authority to make such rules as may be necessary or advisable to carry in effect the purposes of the law; and sec.12 which requires the board to ensure that applicants satisfy a moral character review. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on July 24, 1997. TRD-9710018 William Treacy Executive Director Texas State Board of Public Accountancy Effective date: August 21, 1997 Proposal publication date: June 20, 1997 For further information, please call: (512) 505-5566 22 TAC sec.511.175 The Texas State Board of Public Accountancy adopts new sec.511.175, without changes to the proposed text as published in the June 20, 1997, issue of the Texas Register, (22 TexReg 5887). The new rule allows for the extension of the board's statutory investigative file confidentially to eligibility investigations. The new rule will function by extending confidentiality coverage to this new investigative area. No comments were received concerning adoption of the rule. The rule is adopted under Texas Civil Statutes, Article 41a-1, sec.6, which provides the Texas State Board of Public Accountancy with the authority to make such rules as may be necessary or advisable to carry in effect the purposes of the law; and sec.12 which requires the board to ensure that applicants satisfy a moral character review and sec.25 which makes the board's investigative files and investigations of candidates and licensees confidential. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on July 24, 1997. TRD-9710019 William Treacy Executive Director Texas State Board of Public Accountancy Effective date: August 21, 1997 Proposal publication date: June 20, 1997 For further information, please call: (512) 505-5566 22 TAC sec.511.176 The Texas State Board of Public Accountancy adopts new sec.511.176, without changes to the proposed text as published in the June 20, 1997, issue of the Texas Register, (22 TexReg 5887). The new rule allows for a clearer understanding of which activities will make an applicant's moral character unacceptable to the board. The new rule will function by describing those activities which will make an applicant's moral character unacceptable to the Board. No comments were received concerning adoption of the rule. The rule is adopted under Texas Civil Statutes, Article 41a-1, sec.6, which provides the Texas State Board of Public Accountancy with the authority to make such rules as may be necessary or advisable to carry in effect the purposes of the law; and sec.12 which requires the board to ensure that applicants satisfy a moral character review. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on July 24, 1997. TRD-9710020 William Treacy Executive Director Texas State Board of Public Accountancy Effective date: August 21, 1997 Proposal publication date: June 20, 1997 For further information, please call: (512) 505-5566 TITLE 25. HEALTH SERVICES PART XVI. Texas Health Care Information Council CHAPTER 1301.Health Care Information Collection and Release of Hospital Discharge Data 25 TAC sec.sec.1301.11-1301.19 The Texas Health Care Information Council (Council) adopts new sec.sec.1301.11- 1301.19, relating to the collection and release of hospital discharge data. Section 1301.11 and sec.sec.1301.13-1301.19 are adopted with changes to the proposed text as published in the February 11, 1997, issue of the Texas Register (22 TexReg 1560). New sec.1301.12 is adopted without changes and will not be republished. The changes in the proposed sections respond to public comments. The Council's representative from the Office of the Attorney General has advised that the changes made in the sections as adopted affect no new persons, entities, or subjects other than those given notice and that compliance with the adopted sections will be less burdensome than under the proposed sections. Accordingly, republication of the adopted sections as new proposed rules is not required. The Council's initial proposed Hospital Discharge Data (HDD) rules were published in the August 23, 1996, issue of the Texas Register (21 TexReg 7939). The Council received numerous comments, requiring considerable analysis. Because the Council determined that the initial comments warranted substantial revisions to the proposed sections, the Council withdrew the initial proposed sections. After incorporating many suggestions from the public comments, the Council proposed this revised version of the HDD rules in February 11, 1997, issue of the Texas Register (22 TexReg 1560) along with a preamble responding to public comments received on the first version of the proposed sections. The new sections facilitate implementation of the statewide health care data collection system recommended by the Committee on Public Health in the Interim Report to the 74th Texas Legislature, November 1994 and mandated in House Bill (H.B.) Number 1048, of the 74th Legislature, codified in Title 2, Health and Safety Code, sec.sec.108.001-108.015. Subsequent to the date that the new sections were proposed the 75th Legislature enacted Senate Bill (S.B.) 802, effective September 1, 1997. The Council recognizes that S.B. 802 necessitates amendments to the new sections and intends to propose the necessary amendments at its August 1997 meeting. Hospital discharge data is an integral part of the statewide health care data collection system the Council is charged to develop by Health and Safety Code, sec.108.006(a) "to facilitate the promotion and accessibility of cost-effective, good quality health care." The data to be collected by the Council pursuant to the new sections may be used by consumers, employers, health insurance plans, public health officials and health care providers for many purposes. For example, with proper risk and severity adjustments, the data supports reasonable comparisons of hospital charges, mortality rates and lengths of stay. The data allows employers and health insurance plans to make better informed choices when building provider panels. The data also provides information on the incidence and prevalence rates of certain diagnoses and procedures that require inpatient treatment. From a public health perspective the data can help identify high incidence geographic areas or at risk populations meriting public action and can help identify those hospitals delivering the best results so that other facilities can be encouraged to adopt "best practices". The Council has designed the process for data collection to meet the explicit requirements of the enabling statute, to obtain data that is as complete and accurate as possible, and to impose only a reasonable burden on the reporting hospitals. In designing the process the Council has consulted with the National Association of Health Data Organizations, studied the approaches and experiences of other state health data systems, and received extensive input from Texas hospitals. As required by Health and Safety Code, sec.108.006(a)(2), the Council will contract for data collection with the Texas Department of Health (TDH). New sec.1301.11 defines terms used elsewhere in the adopted sections. New sec.1301.12 requires reporting on all inpatients, describes the proper reporting of mother and newborn data, as well as multiple unit stays within the same hospital, describes reporting procedures for both insured and uninsured patients, notifies hospitals of the manner by which they will be advised of the address to send data, allows hospitals to designate an agent for data reporting purposes, and informs hospitals of the procedures to be followed for data verification by the Council through audit. The following paragraphs describe the details of sec.1301.12 and the Council's rationale in developing this section. The data elements hospitals are required to submit under the new sections are those defined by the National Uniform Billing Committee. This set of data elements is commonly referred to as the UB-92 data set. In addition to the minimum data set (MDS), hospitals are required to submit any other UB-92 data elements that were submitted to the payer(s) for a particular patient. The new section requires reporting on insured and uninsured patients. This requirement is consistent with the purpose of the data: to provide a complete view of patients treated in Texas hospitals. Because an estimated 27% of Texans have no health insurance, to collect data only on insured patients would not provide a complete or accurate picture of the incidence of diagnoses or procedures. Included in the Council's statutory charge is the duty to report to the legislature, the governor, and the public on "the quality and effectiveness of health care and access to health care for all citizens of this state." Without reliable data on the uninsured segment of the Texas population, the Council will be unable to comply with its complete statutory mandate. The Council has attempted to reduce the administrative burden on hospitals by not requiring them to submit a single comprehensive discharge record for each patient. Instead the new sections allow hospitals to submit interim and supplemental bills just as they do for third party reimbursement. The Council takes the responsibility for consolidating multiple records on a single discharge. This procedure allows hospitals to submit interim, revised, final and other types of bills as they are generated and eliminates the need for them to "warehouse" bills prior to submitting them to the Council. A data format is the way data elements are physically arranged on a paper or electronic record. Section 108.009(h) of the Council's enabling legislation requires it to accept data "in universally accepted standardized forms approved by the Council". The only universally accepted standardized paper form of which the Council is aware is the Health Care Finance Administration (HCFA) Form 1450; commonly referred to as the UB-92. Providers that do not possess electronic data processing capacity may submit data using this form. New sec.1301.13 requires data to be submitted at least quarterly. If, however, hospitals wish to submit data more frequently, they may do so. The exemption process is designed to require hospitals to give notice of their submission schedules to allow the Council to ensure reporting systems are working properly. The statute requires, and the new section provides for the creation of a public use data tape. The rule attempts to balance the public's right to the data with the public's interest in the validity of the data and protection of patient confidentiality. The Council's goal is to release public use data quarterly; about six months after the end of the reporting period. Creation of the public use data tape from the data submitted by hospitals requires several steps. First, discharge records must be consolidated so there is one record covering each discharge. Second, uniform patient, uniform physician, uniform provider and uniform payer codes must be added by Council staff. Third, any data elements that could be used to identify a patient or physician must be deleted. Fourth, zip codes must be converted to multi-zip code areas and rural data must be aggregated. Hospitals and other providers are allowed to attach comments to the data. The discharge records will then be run through software to assign risk and severity scores to each record. The Council has decided that no public use data will be released without risk and severity scores. The software to be used will be selected by the Council following the report of its Technical Advisory Committee September 1, 1997. The purpose of these scores is to allow a fair comparison of hospital outcomes, charges and lengths of stay. The Council has also decided not to release any data until it has six months of data available. This is to prevent erroneous conclusions from being drawn from data based on a small sample. New sec.1301.15 sets out the specific process for requesting and obtaining an exemption from the requirement for electronic filing of discharge reports. S.B. 802 directs the Council to accept electronic filings not only in the UB 92 format but also in "other universally accepted standardized forms" that hospitals "use for other complementary purposes." Accordingly, after adopting the new sections requiring electronic filings on the HCFA UB-92 Electronic Format (Versions 004.1 and 004.0), the Council intends to amend the new sections to authorize filings using the ANSI-X12 837 Format developed by the American National Standards Institute and to create a process whereby hospitals may be granted authority to file using another format if they can demonstrate that the formats are "universally accepted standardized forms." New sec.1301.15(b) clarifies how a hospital is to initiate a request for exemption. New sec.1301.16 describes the process to be established for acceptance of discharge reports by the Council's executive director and for the correction of reporting deficiencies or errors. Specifically sec.1301.16(c) addresses errors in the data elements in individual patient bills. All bills received, regardless of medium, will be input to the Council's vendor's system. This is the same system on which hospitals now submit bills to Medicare, Blue Cross and other payers. Thus many hospitals are already familiar with this edit and correction process. Each bill will be edited on-line and either accepted or rejected for errors. If accepted, the discharge file will be deposited in the Council's electronic mailbox. If rejected, a notice with error messages will be placed in the hospital's electronic mailbox. Any discharge file that is rejected is deleted from the system and must be resubmitted. Hospitals that submit by modem will normally know immediately which records have been accepted and which rejected. The turnaround time for error reports for hospitals that submit bills on paper, tape or diskette will be longer because of the additional data entry or data conversion steps. The Council anticipates that full documentation of the edits to be applied will be provided to hospitals during hospital training sessions to be offered by or at the direction of the Council. The edits performed in the vendor's system are at the level of individual bills. In combining multiple bills on the same discharge, in tracking individual patients across multiple discharges and in looking at the overall pattern of data received from a hospital, the Council will compare the data received to data on the hospital from other sources and perform additional logic and consistency checks on the data. New sec.1301.17 provides time lines for an editing process. The vendor provides on-line editing and error notification of electronically submitted discharge records. The section provides that definitions of all data edits will be made available to hospitals to allow them to pre-edit their data. This is intended to reduce the cost and the time required to obtain accurate data. The section requires that hospitals give physicians and other health professionals the opportunity to review, correct, and comment on any discharge records on which they are shown as an admitting or treating the patient. The rule requires that a hospital's chief executive officer or the officer's designee certify the completeness and accuracy of the data submitted to the Council each quarter. The section delegates authority to the Council's executive director to determine when the data is complete and accurate enough for public use. The section is structured so that Council review of hospital medical records is an exception rather than routine occurrence. To facilitate physician, hospital, and other health professional review and certification of data, the Council will provide quarterly an electronic data file to each reporting hospital containing the consolidated record for each patient discharged from that hospital that will allow physicians and other health professionals to view and append notes to records for which they are shown as the admitting or treating physician. The process for certification of quarterly hospital data in the adopted version of sec.1301.17 varies from the proposed version. As adopted the executive director will provide each reporting hospital with a file of its data each quarter. The data file will have one record for each patient discharged by that hospital during the reporting quarter based on all discharge files the hospital has submitted regarding that patient. The hospital is responsible for reviewing the quarterly file and certifying it as complete and accurate, subject to any comments or corrections of data the hospital wishes to make. The hospital must afford its physicians or other health professionals the opportunity to review records of patients they admitted or are shown as treating. This change has required the creation of new subsections (a) and (b) and the renumbering of the previous subsections. The adopted sec.1301.18 contains language authorizing the executive director to establish the process and procedures necessary to create the various codes and identifiers required by the statute and by other sections of these rules. sec.1301.19: The Council is required to prescribe by rule the process for providers to submit data consistent with sec.108.009. The components of a process to submit data includes a definition of the data elements to be submitted for coded data elements (e.g. diagnosis and procedure codes), a definition of the coding systems to be used, a definition of the format(s) in which the data will be submitted, a definition of the media on which data will be submitted, a schedule for submission and a location for submission. The National Uniform Billing Committee defines data elements and codes for certain of these elements. It does not define a data format for paper or electronic submission of hospital bills. The paper format for submission of inpatient hospital bills, commonly referred to as a "UB-92" is defined by the Health Care Finance Administration (HCFA) of the United States Department of Health and Human Services (DHHS). This paper format is also known as a "HCFA 1450," and is the only universally (or at least nationally) accepted paper format. In instances where the Council allows hospitals to use paper bills as the medium for data submission, the Council requires this format. The Council has determined that the electronic format used for the most hospital bills is the HCFA electronic version of the form 1450 (HCFA UB-92 Electronic Format (Versions 004.1 and 004.0)); also known as the National Standard Format (NSF). Virtually all hospitals submit Medicare bills to HCFA electronically because it speeds payment and reduces billing costs. More than 40% of all inpatient hospital bills are for Medicare patients. The proposed section allowed hospitals to submit data in this format and that has not changed. Records will be accepted in the current and immediately preceding version of the format. The data format maps the UB-92 data elements and provides unused fields for additional data elements. The Council recognizes that some hospital personnel who work with the UB-92s are unfamiliar with the HCFA UB-92 Electronic Format (Versions 004.1 and 004.0). The Council will make available to anyone requesting it a crosswalk between the UB-92 elements and the HCFA UB-92 Electronic Format (Versions 004.1 and 004.0). sec.1301.19(f): The Council has deleted this section because these specifications are part of the HCFA UB-92 Electronic Format (Versions 004.1 and 004.0) and do not need to be separately presented. The Council has carefully considered all comments received on both versions of the proposed sections. The Council has considered the costs and benefits of various alternatives for all elements of the data collection process and believes the arrangements embodied in the adopted sections represent a cost- effective approach to meeting the requirements of the authorizing legislation. As with any new state program, the Council expects to find opportunities to improve the process as experience is gained. Representatives of the following interested entities, groups, or associations presented testimony, citing one or more references, against the proposed sections published in the February 11, 1997, issue of the Texas Register (22 TexReg 1560) at the Public Hearings listed hereafter: March 3, 1997-HCIA; Texas Department of Mental Health and Mental Retardation; Baylor Health Care Systems; Parkland [Memorial] Health and Hospital System; Memorial Health System; Healthcare America, Inc.; Baylor Health Care System; March 10, 1997-South Austin Medical Center and Columbia St. David's Healthcare Systems; Columbia Mainland Medical Center; Columbia Doctor's Regional Medical Center; Hendrick Medical Center; Presbyterian Healthcare System; Scott and White Integrated Healthcare Delivery System and Texas Health Information Management Association; Providence Health Center; Park Plaza Hospital-Houston; Texas Hospital Association; Seton Healthcare Network; Daughters of Charity Information Services Entity. Each of the following interested entities, groups or associations presented written comments, citing one or more references against the proposed sections published in the February 11, 1997, issue of the Texas Register (22 TexReg 1560): 3M Health Information Systems; Baylor Center for Extended Care, Abilene; Baylor College of Medicine; Baylor Health Care System; Baylor Institute for Rehabilitation; Baylor University Medical Center; Baylor/Richardson Medical Center; Citizens Medical Center; Columbia Doctor's Regional Medical Center; Columbia Mainland Medical Center; Columbia Spring Branch Medical Center; Columbia St. David's Healthcare System; Consumers Union; Cypress Fairbanks Medical Center, Inc.; Daughters of Charity National Health System; Driscoll Children's Hospital, Corpus Christi; Friend and Associates, L.L.P.; Gonzales County Hospital District; GranCare Specialty Hospital of Houston; Greater San Antonio Hospital Council; HBO and Company; Harris Methodist, Fort Worth; Health Care Information Association; Healthcare America Incorporated; Hendrick Medical Center; Hermann Hospital, Houston; Houston Columbia/ HCA and Columbia Mainland Medical Center; Irving Healthcare System; Jenkins and Gilchrist; Memorial Healthcare System; Methodist Hospitals of Dallas; Methodist Hospital, Houston; Methodist Hospital, Lubbock; Park Plaza Hospital, Houston; Parkland Memorial Health and Hospital System; Presbyterian Healthcare System; Providence Health Center; Quest Hospital, Amarillo; Scott and White Hospital; Seton Healthcare Network; Seton Healthcare Network, Austin; Sisters of Charity of the Incarnate Word Health Care System; St. Luke's Episcopal Hospital; Summit Hospital of Central Texas; Texas Children's Hospital, Houston; Texas Department of Mental Health and Mental Retardation; Texas Health Information Management Association; Texas Hospital Association; Texas Medical Association; Texoma Medical Center, Denison; Titus Region Medical Center. General Comments Unrelated to Specific Sections. Costs to Hospitals of Compliance with the Rule. Numerous comments expressed concerns regarding the costs that the hospitals would incur to comply with the February 11, 1997 version, specifically referencing the preamble statement of the estimated total cost to all the hospitals that are required to submit data to the Council. Concerns over costs, and the Council's responses, fall into the following categories: 1. Quarterly submission of data. Several comments indicated that hospitals did not today retain all UB-92 data for an entire quarter, and to do so would require them to incur substantial programming costs and hardware to build data repositories to store data for later submission to the Council. While the statute does not allow the Council to require hospitals to submit data more often than quarterly, the new sections allow hospitals to submit bills daily if desired. No additional data storage at the hospital level is needed to comply with the section as adopted. 2. Standard data format. Several comments indicated that hospitals would incur substantial costs from having to reprogram their billing systems to produce bills in the HCFA UB-92 Electronic Format (Versions 004.1 and 004.0). The Council has met with information systems managers representing large and small hospitals on this issue and believes these costs need not be incurred to comply with these rules. The Council will accept bills in the HCFA UB-92 Electronic Format (Versions 004.1 and 004.0) . Almost all hospitals, and all those that submitted comments, bill Medicare electronically to reduce reimbursement lag and billing expense. All Medicare and Medicaid bills must be submitted electronically in the HCFA UB-92 Electronic Format (Versions 004.1 and 004.0). These bills represent a significant portion of the total number of bills a hospital produces. Therefore, either the hospital's billing system can already generate bills in the HCFA UB-92 Electronic Format (Versions 004.1 and 004.0), or the hospital is sending a print image file to a data conversion firm. If the hospital is generating its own HCFA UB-92 Electronic Format, there should be no significant reprogramming necessary to generate a file of all bills in that format. The Council is aware of several firms that currently take print image billing files from Texas hospitals and convert them to the HCFA UB-92 Electronic Format (Versions 004.1 and 004.0) for Medicare, Medicaid and to this or other formats for other payers. These firms have the capability of generating a complete billing file in the HCFA UB-92 Electronic Format (Versions 004.1 and 004.0) for their hospital clients and forwarding it to the Council. Hospital information systems managers advise the Council that these firms charge hospitals from $0.25 to $0.50 per bill for converting the hospital's print image file and forwarding it to payers. Hospitals that utilize these companies are already paying the per bill conversion cost for their bills that go to Medicare or Medicaid. If the bill is to go to a payer using a different format, or if the bill is for an uninsured patient and is only being submitted to the Council for reporting purposes, the hospital may have to incur a charge of $0.25 to $0.50 per bill for the conversion to the HCFA UB-92 Electronic Format (Versions 004.1 and 004.0). In 1995 there were total of 2.24 million admissions/discharges from Texas hospitals based on the 1996/1997 AHA Hospital Statistics. The Council is advised that an average of two bills per discharge is reasonable for planning purposes. This means a total of 4.48 million bills annually. Assuming 50% of Texas hospital bills are currently submitted to Medicare or Medicaid in the HCFA UB-92 Electronic Format (Versions 004.1 and 004.0), the cost for submitting these bills to the Council in this format will range from nothing to a few cents per bill. For planning purposes we will assume a cost of $.10-$0.25 per bill whether the hospital does the work itself or uses a conversion company. For the other 50% of hospital bills, the cost will range from nothing to $0.50 per bill depending on whether: (1) the hospital already has the capability to convert and transmit the bill itself; (2) the bill is already being converted to the HCFA format for that payer; and (3) hospitals and the Council can work together to convince data conversion firms to send a copy of the data in the HCFA UB-92 Electronic Format to the Council's vendor at no or a small cost to the hospital. For planning purposes the Council assumes a cost of $0.50 per bill. This leads to the following calculations: 4.48 million bills x 50% x $0.25 = $560,000; 4.48 million bills x 50% x $0.50 = $1,120,000; Total Estimated Conversion Cost = $1,680,000. Therefore the Council estimates annual conversion costs for hospitals to submit bills to the Council in the HCFA format will not exceed $1,680,000. The Council has used a worst case scenario in developing these costs and believes that actual costs will be less than calculated. Hospital admissions have declined since 1995. Additionally, the Council notes that Public Law 104-191 enacted by Congress in 1996 directs the development of a single U.S. standard all payers must accept by 1998. When this standard is developed the Council will accept data filings in the standard format, thus eliminating billed claim conversion costs altogether. 3. Submission of minimum data set on uninsured patients. Some comments suggested that hospitals may incur substantial costs to generate the Council's minimum data set in the HCFA UB-92 Electronic Format (Versions 004.1 and 004.0) for those uninsured patients for whom the hospital would not normally have generated a bill. The Council agrees that hospitals will incur costs to provide data on uninsured patients. The Council is required by sec.108.006(9)(D) of its enabling legislation, however, to make reports to the legislature, governor, and the public on "the quality and effectiveness of health care and access to health care for all citizens of this state." If hospitals do not report discharge data on uninsured patients, then an information gap will exist for a significant population of this state's citizens. The Council believes that its statutory duties require the collection of discharge data on uninsured patients. 4. Submission of social security numbers, race and ethnicity. Many hospitals commented that the requirement that they collect and submit each patient's social security number, race and ethnicity would generate costs for reprogramming systems and training staff. The Council agrees that certain costs will be attributable to the collection of this data and has omitted collection of this information in the adopted sections. The Council is required by S.B. 802, however, to collect patient race and ethnicity information after September 1, 1997, and will publish a proposed amendments to these sections for the collection of this information in the future. The Council is also directed to develop uniform patient identifiers. The Council may determine that amendments providing for the reporting of patient social security numbers are needed for this purpose. Comments and Changes Related to Specific Sections: sec.1301.11, Definitions: One comment suggested the definitions for "discharge file" and "discharge report" need to be clarified to say they represent a "snapshot of the patient at discharge". The Council disagrees with the suggested clarification. A discharge file corresponds to a single patient bill. There will be one or more bills for each patient, except as noted. If the hospital issues an interim bill for a patient prior to discharge, or a revised bill for a patient several weeks after discharge, there will be a separate discharge file corresponding to each bill. The discharge report is a group of discharge files for various patients submitted by a hospital at least quarterly, but as often as each hospital wishes. One comment expressed concern whether the definitions of "facility identifier" and "uniform payer identifier" implied that the names of the facilities (hospitals) and payers associated with the identifiers would not be made public. The Council agrees and has added language to both definitions to clarify that the relationship of the identifiers and the names of the facilities and payers is public information. One comment suggested the definition of "Uniform Physician Identifier" should be limited to persons licensed to practice medicine under the Medical Practice Act (Article 4495b, Vernon's Texas Civil Statutes). The comment recommended that a separate identifier be created to identify other health care professionals who are reported by a hospital to be admitting or treating a hospital inpatient. The Council agrees and has modified the definition of "uniform physician identifier" and created a new definition for "uniform other health professional identifier". sec.1301.12. Collection of Hospital Discharge Data. One comment indicated that the Veterans Administration, for example, provides services to so many inpatients within the state that failure to include their data could leave gaps in health information on Texas residents. To the extent that military hospitals treat Texas residents (as opposed to military personnel temporarily stationed at Texas bases), they should also be encouraged to participate to get an accurate picture within the state. The Council agrees and has added language authorizing the executive director to work with exempted providers to encourage them to voluntarily participate. sec.1301.12(b): One hospital asked how hospitals were to report patients who were served in the acute care portion of a hospital and were then transferred to a diagnosis- related group (DRG)-exempt unit of that hospital. Such units could be skilled nursing units, psychiatric units, comprehensive medical rehabilitation units or long-term care units. The answer depends upon the payer. The majority of these patients are Medicare patients. Medicare requires that the hospital bill separately for the patient's acute care admission and for the admission to the DRG-exempt unit. The hospital should therefore submit to the Council a separate discharge record for the admission to each unit or facility. The Council will use the data elements on both records to assign a unique patient identifier to provide a clear picture of the overall inpatient episode. Other payers may require the hospital to provide a single bill for the total stay. If so, the hospital would provide the Council with one discharge record. The Council believes the data elements on the record (e.g., revenue codes, conditions and occurrence codes, etc.) will allow proper interpretation of the data for analytical purposes. This approach will minimize any data processing burdens on the hospitals. The Council has also provided that on each patient record on the public data tapes that acute and subacute care days will be reported separately. Several comments were received offering differing opinions of how the rule should handle newborns. Several comments indicated that they believed the proposed section requires hospitals to report all newborns consistently, either all on separate bills or all on the same bill with the mother. The Council disagrees with these comments. This new section instructs hospitals to report newborns as they were actually billed to the insurance carrier and requires separate records for births only where there is no third party coverage. The Council believes this approach minimizes incremental work for hospitals to satisfy the reporting requirements. Another comment expressed concern as to whether the Council could perform the processing necessary to separate newborns on joint bills. The Council plans to study this issue using the test data hospitals are to submit and determine if a change to the rule is needed. One hospital commented that it should be allowed to submit interim bills rather than having to consolidate all bills into one discharge record. Subsection (b)(2) allows interim submissions. Another hospital commented that the new section should allow the option to combine all bills related to a single patient discharge into one discharge file. The adopted section allows but does not require this practice. One hospital commented that inpatients frequently have a series of multiple payers, each requiring the previous payers' payment information to be included with their claim so they can calculate the remaining balance to be paid. The hospital believes this required additional payer information will cause hospitals to frequently and continuously update previously submitted claims data to the Council leading to additional incurred cost. The Council disagrees with this analysis. The adopted section does not require hospitals to develop an archival data base. The section authorizes hospitals to send the Council copies of the bills as they are sent to payers. This includes revised and resubmitted bills whenever they occur. The adopted section does not require hospitals to maintain the earlier bills sent to the Council and update them. Numerous hospitals commented that hospitals should not be required to submit discharge records on self-pay and charity care patients for whom a UB-92 had not been sent to any payer. Some hospitals indicated that such patients are 15% to 25% of their total patients. One hospital commented that it currently uses a vendor to take its data and process the data to the HCFA UB-92 Electronic Format (Versions 004.1 and 004.0). The hospital pays the vendor a charge per record reformatted. At present only records to be billed electronically are sent to the vendor. Using the vendor to prepare records for the Council on patients not currently billed electronically will increase payments to the vendor and hence increase hospital costs. The particular hospital indicates this would increase the number of records processed by its vendor by 20-25%. The Council agrees that to the extent the furnishing of discharge data on self-pay and uninsured patients will cause the generation of additional record keeping, hospitals will incur increased costs. Section 108.006 of the Council's enabling legislation directs the Council to "develop a statewide health care data collection system to collect health care charges, utilization data, provider quality data, and outcome data to facilitate the promotion and accessibility of cost-effective, good quality health care." Additionally, the Council is required by sec.108.006(9)(D) of its enabling legislation to make reports to the legislature, governor, and the public on "the quality and effectiveness of health care and access to health care for all citizens of this state." The Council cannot carry out these mandates by looking only at the health services delivered to insured patients. If hospitals do not report discharge data on self-pay and charity patients, then an information gap will exist for a significant population of this state's citizens. The Council believes that its statutory duties require the collection of discharge data on uninsured patients. The Texas Department of Mental Health and Mental Retardation (TDMHMR) objected to being required to submit UB-92 data on its patients because most are indigent and are not billed. The Council is unable to find a reporting exemption for TDMHMR facilities in its enabling legislation. 1301.12(g): One comment suggested that the Council pay the cost of copying any hospital records it requested pursuant to this section. Another comment suggested that this section more closely track the statutory language in sec.108.007(a) regarding the role of the Texas Department of Health (TDH). Another comment noted that any reviews of medical records could be costly to the hospital and impose an administrative burden. The Council disagrees with these comments. The adopted section closely tracks sec.108.007 of the Council's statute. Any review of records by the Council is in the nature of an audit of the hospital for the enforcement of the statute and the verification of the data. The Council does not believe it is customary for the State to pay for copies of records in this situation. Additionally, the Council notes that the legislature did not authorize the Council to pay for the costs of the records. The Council believes the proposed rule provides the "reasonable rules and guidelines" mentioned in sec.108.007. 1301.13(a): One comment recommended that the Council predicate the start date of the program, meaning the first day of data collection on required elements for all inpatients, upon the contingent effective date of the rule allowing for the passage of a minimum of 90 days between the two. The Council agrees that some delay is appropriate and notes that S.B. 802 provides that a rule which requires the submission of new data elements may not take effect sooner than 90 days after the day that the rules are adopted. Accordingly, although the new sections are effective 20 days after they are filed with the Office of the Secretary of State, the Council has moved back the date for data collection and reporting to begin with discharges occurring January 1, 1998. Numerous comments indicated that 60 days might be inadequate for the hospitals to file discharge reports if they reported only on a quarterly basis. The Council would like to clarify that hospitals may report more frequently than quarterly, if they choose to do so. In arriving at the requirement that hospitals submit and certify their discharge records by 60 days after the end of the quarter, the Council consulted with the National Association of Health Data Organizations regarding the practices in other states operating similar hospital discharge collection systems. The 60-day period appears reasonable, and the Council declines to make any change. Hospitals are only responsible for submitting bills that have been issued by 60 days after the end of the quarter in which the discharge occurred. The Council notes that there may be revised bills submitted for a patient later than 60 days after the end of the quarter in which the discharge occurred. The Council will process these bills in the subsequent quarter and update its data base. 1301.13(b): Because of delays in final adoption of these rules, the Council has moved the period for test data to the first quarter of 1998. This action responds to numerous comments received from hospitals and coincides with the Council's schedule for the development of a data warehouse. One comment requested that data on psychiatric patients be excluded from the test phase because the risk of unauthorized disclosure during the test phase was higher. The Council disagrees with this comment. Patient identifying data elements will not be submitted on any patient. Therefore there is no reason to treat bills for psychiatric patients differently. 1301.13(d): Several commenters said the mention of civil penalties in the rules was harsh and not consistent with the cooperative environment that the Council seeks to develop with health care providers. Another commenter requested a delay in the effective date for the assessment of civil penalties to reflect the spirit of the Council's cooperation with hospitals. The comment recommended a concluding sentence be added to proposed sec.1301.18(c)(1)(C) to read: "During this testing period, no civil penalties will be assessed," and adding a concluding sentence to proposed sec.1301.18(c)(1)(D) to read: "During the last two quarters of 1997 and the first two quarters of 1998, no civil penalties will be assessed." The Council disagrees with these comments. The Council included these references to civil penalties to give fair notice to all concerned of the Legislature's action. The application of such penalties is not automatic. The statute provides that the Attorney General would seek such penalties only at the request of the Council. The Council has no intention of resorting to enforcement actions except as a last resort when all other efforts to obtain cooperation and compliance with the rules have failed. The Council is mindful that there is much trial and error at the start of every data collection program. sec.1301.14: One commenter objected to the limitations on the number of tapes or diskettes per submission because it estimates its quarterly submission would cover 16,000 discharges requiring a large number of tapes or diskettes. The Council declines to remove the restriction. Submitting hospital bill data on magnetic media is intended primarily for use by small hospitals. The Council expects hospitals of this size to transmit bills by electronic data interchange (modem) or to have a vendor do it for them. The Council strongly encourages data submissions of this size to be by modem. One comment noted that proposed sec.1301.14(a)(4) and (b) state that the Council will notify hospitals 90 days prior to changes in the instructions for filing discharge reports on magnetic media or by electronic data interchange, and recommended the method of communicating these changes to hospitals be included. The Council agrees and has added language requiring the executive director to give notice directly in writing to hospitals and their agents. Writing may be by mail or facsimile. Another comment said the 90-day time frame is unrealistic given the time required to rewrite hard coded computer programs. The comment recommended at least 120 to 180 business days be allowed for the process of changing the computer program, test verification and live product production testing. The Council disagrees with this comment. The lead time given should be reasonably related to the magnitude of change in the process. The adopted section gives the executive director discretion to give more than 90 days' notice when necessary. sec.1301.16(b): Several comments indicated that hospitals would need more than ten days for refiling when discharge reports are rejected for failing to satisfy minimum criteria for processing. The Council disagrees with these comments. This section deals only with improper media, physically damaged media or problems with the file structure of the submission. These are errors that would be corrected by the hospital generating and re-sending a replacement file. This would normally be done in a few days from the files used to prepare the original. Several comments suggested that the Council should establish an acceptable error rate and/or error rate threshold. The Council disagrees. The new section delegates to the executive director the authority to determine when a hospital's data is sufficiently complete and accurate. The Council expects the executive director to take a reasonable approach to this question and expects hospital performance to improve over time. Two comments suggested that hospitals would incur the greatest cost correcting errors in inactive accounts, due to manpower and processing. This cost would occur if the hospital holds all discharge files for a quarter and submits them all at once. While the Council cannot require hospitals to submit data more often than quarterly, hospitals may submit data more frequently, even daily if they choose to do so. Once data is transmitted to the vendor's system, edits occur immediately and the hospital will know of any errors immediately. This will eliminate the need to retrieve archived data. This arrangement gives hospitals the ability to submit data on schedules they determine will produce optimal efficiency. One comment asked that hospitals be able to resubmit a rejected discharge file rather than submit corrections to individual data fields. The Council agrees and has made provisions for this to occur. Comments and responses to comments refer to the numbering in the February 11 proposed rule. sec.1301.17(a): Several comments recommended that a "designated person" selected by the CEO or CFO be added to the list of who should be allowed to sign for certification of discharge reports. The Council agrees and has modified this section, deleting reference to the chief financial officer and allowing the chief executive officer to sign the certification or to designate an agent. sec.1301.17 (b): One comment expressed concern over the practicality of having physicians review the accuracy of the data. The comment noted that hospital records to be submitted are not maintained in a format that allows complete review by either the hospital or physicians and that the billing system is a very dynamic database. The comment fears that physician review would require either printing a hard copy of the UB-92 or creation of a system for on-line review. The Council has addressed these concerns by requiring the executive director to supply each hospital quarterly an electronic data file designed to facilitate review by hospitals, physicians, and other health professionals. Comments also expressed concern that the proposed section directs hospitals to require physicians to review and verify the data. The Council disagrees. The adopted section requires only that the admitting physicians have the opportunity to review, request corrections of, and comment on the data. Other comments expressed concern that physicians would violate patient confidentiality by reviewing records in which they have no legitimate interest. The Council disagrees and believes that the system will contain adequate safeguards to protect patient confidentiality by limiting physician access only to records of patients for whom they are the admitting or treating physicians. sec.1301.17 (c): One commenter expressed concern that data will not be available to the public until seven months after the end of each quarter, which means data from the first part of the quarter will be ten months old when released. The comment noted that the data is due at the THCIC two months after the end of the quarter and giving the facility four more months to "check" it seems excessive. The comment recommended that the rules clearly state that any data not certified within this period of time is deemed acceptable and will be released to the public. The commenter hopes after the system at the Council has been up and running for a while, this time frame will be shortened. The comment is concerned that due to the lag time of public dissemination, the Council's data will not be attractive and possibly irrelevant to those seeking Texas information. A review of the data release schedules in other states suggests that six months is typical. The Council agrees that it would be desirable to make the data available more quickly and this may be possible in the future. At the initiation of the program, however, the Council believes the schedule in the new section is reasonable. sec.1301.17(d): Comments were received asking that the Council waive in advance all civil penalties during initial implementation. The Council disagrees with this comment but has no intention of asking for such penalties unless extreme situations should arise. sec.1301.18: One commenter opposed the release of public use data files or statistical compilations based on those files. The objections to release of the public use data file to the public in this comment apply whether or not the records include quality adjustment factors. The Council disagrees with this comment. The provisions of the statute concerning confidentiality and general access to data reinforce the view that the Council has the obligation to create a public use data file from the hospital discharge data and make this file available to the public. The Council is required to use data received by the Council for the benefit of the public and to make determinations on requests for information in favor of access. The Council's enabling legislation, sec.108.013(a) makes information received by the Council, once modified to protect patient and physician confidentiality, subject to the Open Record's Act. Several commenters questioned whether the release of a public use data file would lead to correct perceptions of the comparative quality of various hospitals. The Council believes that by providing risk and severity adjustment scores which will then be applied to the data by users, the risk of incorrect perceptions of comparative quality should be minimized. Several comments questioned the release of hospital gross charges because few patients actually pay gross charges. The Council believes gross charge data should be included on the public use data file. Charge data in conjunction with data such as Medicare cost reports and the TDH/THA/AHA annual hospital survey can be analyzed to produce reasonable comparative estimates of hospital costs and net reimbursement for various services. One comment disagreed with the Council's determination that the statute did not permit inclusion of the uniform patient identifier on the public use data file. We believe the question has been clarified by S.B. 802 which requires the Council to include uniform patient, physician and other provider identifiers on the public use data file. The public use data file will not, however, reveal the name of any patient or physician. Several comments asked for some "adjustment in the data itself." The Council disagrees with these comments. The addition of risk and severity scores is the professionally accepted approach to providing meaningful comparisons of health care providers. Several comments asked that the public use data file indicate whether a hospital is a children's specialty hospital or a teaching hospital. The Council agrees it would be helpful to have this information on each patient record, and the adopted section provides for the inclusion of this information. sec.1301.19: Comments were received from many hospitals that the format for data submission was nonstandard and would require substantial reprogramming of computer systems on the part of Texas hospitals, require extensive lead time and subject them to great expense. The commenters generally requested that hospitals be able to submit data in whatever form they choose, leaving it to the Council to translate the data to a standard format. The Council disagrees with these comments. As stated previously in this preamble, the Council has determined that the electronic format used for the most hospital bills is the HCFA UB-92 Electronic Format (Versions 004.1 and 004.0), the electronic version of the form 1450. Any hospital that submits Medicare bills to HCFA electronically must use the HCFA UB-92 Electronic Format UB-92 (Versions 004.1 and 004.0). Most hospitals have the capability to submit data in this format. The Council does not interpret sec.108.009(h) of its enabling legislation as authority for hospitals to file data in whatever form they choose. One comment indicated that its hospital policy was to redact patient names and replace them with patient account numbers or medical record numbers before releasing data. Adopted sec.1301.19(e) removes the requirement that hospitals furnish patient names. Several commenters stated that federal statutes and regulations restricting the release of information on psychiatric and substance abuse patients might prevent hospitals from supplying information on these patients, and thus require changes in the definition of "Inpatient." The Council has removed from these rules the requirement that patient identifying data elements be submitted on any patient. Some hospitals objected to the requirement that hospitals collect and report the patient's Social Security Number. They further objected to identifying the reason no Social Security Number was available for patients without one. Some said this would require additional work by hospital staff. Others said that requesting it might be offensive to the patient for various reasons, including it as an attempt to screen out aliens. Hospitals also said the Social Security Number should not be collected because it was not part of the UB-92 data set. The Council understands that Social Security Numbers are not always available or reliable. The Council agrees that it is not necessary to assign codes for reasons the social security number is missing from a given discharge. The adopted sections do not require the reporting of Social Security Numbers. The absence of this information will prevent the Council from initially assigning a Uniform Patient Number as required by S.B. 802. The reporting of Social Security Numbers may be the subject of a future rule-making proceeding. Some commenters questioned the statutory authority of the Council to collect data on patient race and ethnicity because these data elements are not part of the UB92 data set. The Council has omitted the requirement that hospitals report patient race and ethnicity data from sec.1301.19 as adopted. Some hospitals objected to the source of payment codes that hospitals would be required to use. One commenter indicated that the category for Blue Cross transcends other categories listed such as HMO's and PPO's and further noted that other unusual hybrid combinations of HMO's and PPO's exist in the marketplace. Another hospital questioned how to code when a patient is covered by multiple payers. The Council, through its training sessions, will provide direction on how to appropriately categorize these unique situations to ensure consistency across reporting hospitals and data accuracy. One commenter cited problems with the "self-insured" category noting that "there is no way to look at an insurance card and determine if an individual's company is self-insured." The Council agrees and has omitted this category. One comment requested a clarification between the categories of "charity/self pay" and "other self pay." The Council recognizes the confusion and has omitted the "other self pay" category. One hospital indicated they would incur increased costs to comply with the Council's source of payment codes. The Council disagrees. The source of payment code list follows the codes and categories already in place as determined by the National Uniform Billing Committee with four additional categories. These four categories are also already used by a large group of Texas hospitals in other data reporting programs. Therefore, the Council adopts the proposed source of payment code list with the two omissions noted previously. The new sections are adopted under the Health and Safety Code, sec.108.006(a) and sec.108.009. The Councils interprets sec.108.006(a) as authorizing it to adopt rules necessary to carry out Chapter 108, including rules concerning data collection requirements, to prescribe by rule the process for providers to submit data. The Council interprets sec.108.009 as authorizing it to adopt rules for the implementation of data submission in stages to allow for the development of systems for the collection and submission of data and as requiring it to develop data submission procedures for providers lacking electronic submission capabilities. sec.1301.11.Definitions. The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise. Batch file-A set of computer records as specified in sec.1301.19 of this title (relating to Discharge Reports-Records, Data Fields and Codes) which contains one or more discharge files and other required header and trailer records. A batch contains discharge files for only one hospital. Charge-The amount billed by a provider for specific procedures or services provided to a patient before any adjustment for contractual allowances, government mandated fee schedules or write-offs for charity care, bad debt or administrative courtesy. The term does not include co-payments charged to health maintenance organization enrollees by providers paid by capitation or salary in a health maintenance organization. Council-The Texas Health Care Information Council. Discharge-The formal release of a patient by a hospital; that is, the termination of a period of hospitalization by death or by disposition to a residence or another health care provider. Discharge file-A set of computer records as specified in sec.1301.19 of this title (relating to Discharge Reports-Records, Data Fields and Codes) relating to a specific patient. Except for some normal newborn infants there will be one or more discharge files for each inpatient. Discharge report-A computer file as defined in sec.1301.19 of this title (relating to Discharge Reports-Records, Data Fields and Codes) periodically submitted on or on behalf of a Hospital in compliance with the provisions of this chapter. Electronic filing-The submission of computer records in machine readable form by modem transfer from one computer to another or by recording the records on a nine track magnetic tape, computer diskette or other magnetic media acceptable to the executive director. Error-Data submitted on a discharge report which are not consistent with the format and data standards contained in this section or with editing criteria established by the executive director, or the failure to submit required data. Executive director-The chief administrative officer of the Council, or, in the event the Council is without an executive director, the person designated by the chairperson of the Council to perform the functions and exercise the authority of the executive director. Health care facility-A hospital, an ambulatory surgery center licensed under Chapter 243 of the Health and Safety Code, a chemical dependency treatment facility licensed under Chapter 464 of the Health and Safety Code, a renal dialysis center, a birthing center, a rural health clinic or a federally qualified health center as defined by 42 United States Code, sec.1396(1)(2)(B). Hospital-A public, for-profit, or nonprofit institution licensed or owned by this state that is a general or special hospital, private mental hospital, chronic disease hospital or other type of hospital. Geographic identifier-A set of codes and accompanying maps prepared by the Council covering Texas and adjacent states with each code consisting of two or more zip codes, a set of codes and accompanying maps prepared by the Council covering the rest of the United States consisting of three digit zip codes, a set of codes and accompanying maps prepared by the Council covering Canada and Mexico consisting of a separate code for each state or province and a set of codes for each of the other countries. Inpatient-A patient, including a newborn infant, who is formally admitted to the inpatient service of a hospital and who is subsequently discharged, regardless of status or disposition. Inpatients include patients admitted to medical/surgical, intensive care, nursery, subacute, skilled nursing, long-term, psychiatric, substance abuse, physical rehabilitation and all other types of hospital units. Other health professional-a person licensed to provide health care services other than a physician. An individual other than a physician who admits patients to hospitals or who provides diagnostic or therapeutic procedures to inpatients. The term will encompass persons licensed under various Texas practice statutes, such as psychologists, chiropractors, dentists and podiatrists who are authorized to admit or treat patients. Patient control number-A number assigned to each patient by the hospital which appears on each computer record in a patient discharge file. This number is not consistent for a given patient from one hospital to the next, or from one admission to the next in the same hospital. The Council deletes or encrypts this number to protect patient confidentiality prior to release of data. Physician-An individual licensed under the laws of this state to practice medicine under the Medical Practice Act (Article 4495b, Vernon's Texas Civil Statutes). Provider-A physician, health care facility or health maintenance organization. Public use data file-A data file composed of discharge files with risk and severity adjustment scores which have been altered by the deletion, encryption or other modification of data fields to protect patient and physician confidentiality and to satisfy other restrictions on the release of hospital discharge data imposed by statute. Required minimum data set-The data elements which hospitals are required to submit in a discharge file for each inpatient regardless of whether or not the hospital would have prepared a bill for the inpatient. The required minimum data set is specified in sec.1301.19(d) of this title (relating to Discharge Reports- Records, Data Fields and Codes). Rural provider-A provider located in a county with a population of not more than 35,000 according to the most recent United States Bureau of the Census estimate, those portions of extended cities that the United States Bureau of the Census has determined to be rural, or an area that is not delineated as an urbanized area by the United States Bureau of the Census. Submission-A set of computer records as specified in sec.1301.19 of this title (relating to Discharge Reports-Records, Data Fields and Codes) that constitutes the discharge report for one or more hospitals. Submitter-The person or organization which physically prepares discharge reports for one or more hospitals and submits them to the Council. A submitter may be a hospital or an agent designated by a hospital or its owner. Uniform facility identifier-A unique number assigned by the Council to each health care facility in the state. For hospitals this will be the hospital's state license number. Where a hospital operates multiple facilities under one license number, the Council will assign a suffix for each separate facility. The relationship between facility identifier and the name, license number, and assigned suffix of the facility is public information. Uniform other health professional identifier-A unique number assigned by the Council to an individual other health professional who is reported as admitting or treating a hospital inpatient, and composed of numeric, alpha, or alphanumeric characters, which remains constant across hospitals. The relationship of the identifier to the health professional-specific data elements used to assign it is confidential. Uniform patient identifier-A random number assigned to an individual patient which remains constant across hospitals and inpatient admissions. Uniform payer identifier-A unique number assigned by the Council to every third party payer of UB-92 bills. Whenever possible the Council will use established numbering systems such as that maintained by the National Association of Insurance Commissioners. The relationship between payer identifier and the name of the payer is public information. Uniform physician identifier-A unique number assigned by the Council to any physician or other health professional who is reported as admitting or treating a hospital inpatient which remains constant across hospitals. The relationship of the identifier to the physician-specific data elements used to assign it is confidential. sec.1301.13.Schedule for Filing Discharge Reports. (a) For discharges occurring on or after January 1, 1998, hospitals shall file discharge reports according to the following schedule as shown in paragraphs (1)-(4) of this subsection unless a hospital has received an exemption letter from the Council. (1) Each discharge report covering inpatient discharges occurring between January 1 and March 31, inclusive, shall be submitted no later than June 1 of the calendar year in which the discharge occurred. (2) Each discharge report covering inpatient discharges occurring between April 1 and June 30, inclusive, shall be submitted no later than September 1, of the calendar year in which the discharge occurred. (3) Each discharge report covering inpatient discharges occurring between July 1 and September 30, inclusive, shall be submitted no later than December 1 of the calendar year in which the discharge occurred. (4) Each discharge report covering inpatient discharges occurring between October 1 and December 31, inclusive, shall be submitted no later than March 1 of the year following the year in which the discharge occurred. (b) On or before May 31, 1998, hospitals shall submit a discharge report drawn from inpatient discharges occurring between January 1, 1998 and March 31, 1998, inclusive. This discharge report shall be used for test and certification purposes only. The discharge report may include all discharges for the quarter, but the hospital is only required to submit discharge files covering discharges for any consecutive 30 days of the quarter. (c) Extensions to processing due dates may be granted by the executive director for a maximum of ten working days in response to a written request signed by the hospital's chief executive officer. Requests must be in writing, must be received at least five working days prior to the due date and must be accompanied by adequate justification for the delay. (d) Failure to file a discharge report on or before the due date without an extension, is punishable by a civil penalty pursuant to Health and Safety Code, sec.108.014. Discharge Reports. sec.1301.14.Instructions for Filing. (a) Magnetic Media-A discharge report may be filed on computer diskettes, nine track tapes or other magnetic media approved by the executive director. All discharges shall be reported using the same file and record formats specified in sec.1301.19 of this title (relating to Discharge Reports-Records, Data Fields and Codes) regardless of medium. (1) Media specifications are: (A) Diskette: MS-DOS formatted; PC Text file (ASCII); Record length = 192 characters, fixed; 3.5 inch diskette, 1.4 megabyte, high density. (B) Nine track tape: Density = 1600 or 6250 BPI, nine track; Collating sequence = EBCDIC or ASCII; Record length = 192 characters, fixed; Blocking = unblocked; Labeling = no label. (C) Other magnetic media: Discharge reports may be filed on other magnetic media only with the prior written approval of the executive director. The executive director will not normally approve any medium which the Council is not currently equipped to read. (2) Hospitals shall submit no more than one tape or two diskettes per submission, with the following external identification affixed as listed in subparagraphs (A)-(G) of this paragraph: (A) hospital name; (B) facility identifier; (C) reporting period for discharges; (D) number of records by record type; (E) tape density: 1600/6250 BPI (if applicable); (F) collating sequence for tapes (if applicable); (G) the description: "DISCHARGE DATA". (3) Data for more than one hospital may be submitted on a single tape if the submitter provides external identification items (A) through (D) for each hospital. (4) In addition to the provisions of this section, the Council shall document instructions for filing discharge reports on magnetic media and shall make this documentation available to hospitals at no charge and to the public for the cost of reproduction. The Council shall notify hospitals or their designated agents directly in writing at least 90 days in advance of any change in instructions for filing discharge reports on magnetic media. The Council's instructions shall follow Department of Information Resources standards for magnetic media established under Chapter 201 of this Title. (b) Electronic Data Interchange: Discharge reports may be filed by modem using electronic data interchange (EDI). All discharges shall be reported using the same file and record formats specified in sec.1301.19 of this title (relating to Discharge Reports-Records, Data Fields and Codes) regardless of the medium of transmission. Record length is 192 characters for all records. The Council shall document instructions for filing discharge reports by EDI and shall make this documentation available to hospitals at no charge and to the public for the cost of reproduction. The Council shall notify hospitals and their designated agents directly in writing at least 90 days in advance of any change in instructions for filing discharge reports by EDI. The Council's instructions shall follow Department of Information Resources standards for EDI. (c) Paper Forms: Only hospitals granted an exemption from electronic filing of discharge reports may file discharge reports using paper UB-92 billing forms. Hospitals using paper forms are required to provide all data elements specified in sec.1301.19 of this title (relating to Discharge Reports-Records, Data Fields and Codes). (1) All UB-92 forms filed shall be on the form currently approved by the federal Health Care Finance Administration. Photocopies are not acceptable. (2) Hospitals shall submit no more than one batch of paper forms per submission, with the following external identification affixed as listed in subparagraphs (A)-(E) of this paragraph: (A) hospital name; (B) facility identifier; (C) reporting period for discharges; (D) number of forms; and (E) the description: "DISCHARGE DATA". (3) In addition to the provisions of this section, the Council shall document instructions for filing paper UB-92 forms and shall make this documentation available to hospitals at no charge and to the public for the cost of reproduction. The Council shall notify hospitals or their designated agents at least 90 days in advance of any change in instructions for filing paper forms. sec.1301.15.Exemptions from Filing Requirements. (a) Types of Exemptions. (1) Exemption as a Rural Provider. All hospitals except those owned by the federal government shall submit discharge reports to the Council unless the Council determines that the hospital is a rural provider. The executive director shall make a determination of which hospitals are entitled to this exemption at least annually and shall notify qualifying hospitals by publication in the Texas Register and by regular United States mail. Hospitals which are not initially given an exemption may apply for an exemption. This exemption, if granted, may be revoked by the Council should the hospital cease to meet the criteria for exemption based upon the most current data issued by the United States Bureau of the Census. Hospitals that cease to be exempted as rural providers shall be responsible for submitting discharge files on all discharges that occur 30 days after notice is given. The initial discharge report shall not be due until 90 days after notice is given. Subsequent discharge reports are due as specified in sec.1301.13(a) of this title (relating to Schedule for Filing Discharge Reports). (2) Exemptions from Quarterly Filing of Discharge Reports. Hospitals that wish to submit discharge reports to the Council more often than quarterly may do so by requesting an exemption to the standard submission schedule. The Council may also issue general exemptions based on the processing arrangements for data collection. Exemption requests meeting the following criteria as shown in subparagraphs (A)-(D) of this paragraph will normally be approved. (A) The exemption request includes the specific schedule on which the hospital will make its discharge reports which will usually be daily, weekly or monthly. (B) The exemption request states the medium in which submissions will be made. (C) The exemption request will not result in data on any discharge being submitted to the Council at a later date than it would have been if the standard schedule had been followed. (D) The hospital agrees to adhere to the schedule specified in the exemption request until the hospital notifies the executive director in writing that it wishes to end the exemption and report according to the standard schedule, or until a new exemption letter is issued. (3) Exemption from Electronic Filing of Discharge Reports. The Council will grant exemptions from electronic filing of discharge reports only when a hospital can demonstrate that it lacks electronic data processing capacity. If granted, the exemption is valid for one year and must be renewed annually by the hospital. The exemption from electronic filing of discharge reports does not change the data the hospital is required to file on each discharge as specified in sec.1301.19 of this title (relating to Discharge Reports-Records, Data Fields and Codes), nor the schedule for submission specified in sec.1301.14 of this title (relating to Instructions for Filing Discharge Reports). Exemptions from electronic reporting to the Council will not normally be granted unless the hospital shows that it does not currently electronically file UB-92 bills with any payer, or has not done so in the last 12 months prior to the request for exemption. (b) Requests for exemptions shall be submitted and processed using the following procedures as shown in paragraphs (1)-(4) of this subsection. (1) A hospital requesting an exemption shall submit to the executive director a letter requesting the exemption and providing all information necessary to establish the hospital's entitlement to the exemption. The exemption request shall be signed by the chief executive officer of the hospital who shall certify that all information contained in the request is true and correct. (2) The executive director shall review the request for exemption. The executive director may request additional information from the hospital relevant to the exemption request. Within 30 days of receipt of a request, the executive director shall issue a letter granting or denying the exemption. If denied, the letter shall state in detail the reasons for the denial. The executive director shall notify Council members of exemptions requested and the disposition of these requests for information only. (3) If the executive director denies an exemption request the hospital may: (A) resubmit the request along with any additional information or analysis the hospital deems relevant to the executive director. The resubmission shall be considered in the same manner as an initial submission; or (B) appeal the executive director's decision to the Council. The hospital may make an appeal directly to the Council. In making its determination, the Council will consider only those facts and issues which have been previously presented to the executive director. The Council will decide exemption appeals by majority vote of members present. (4) The executive director may revoke any type of exemption if facts indicate that a hospital no longer meets the criteria required for an exemption. The executive director shall give the hospital written notice of the revocation at least 30 days prior to the effective date of the revocation. The notice shall include a detailed statement of the facts on which the revocation is based. A hospital may challenge the revocation of its exemption by: (A) requesting the executive director to reconsider the revocation by submitting any information or analysis the hospital deems relevant to the executive director in writing at least ten days prior to the effective date of the revocation; and (B) by appealing to the Council if the executive director does not grant the request for reconsideration. In making its determination, the Council will consider only those facts and issues which have been previously presented to the executive director. The Council will decide exemption appeals by majority vote of members present. sec.1301.16.Acceptance of Discharge Reports and Correction of Errors. (a) To verify the accuracy of all discharge files prior to public release, the executive director shall establish procedures for the review of all discharge reports to determine whether the report is acceptable, as required by Health and Safety Code, sec.108.011. (b) Upon receipt of a discharge report, the executive director shall determine if it satisfies minimum criteria for processing. If it does not, the executive director shall return the report and state the deficiencies in writing within ten days of receipt. The hospital shall resubmit the report within ten days of notification by the executive director. A discharge report does not meet minimum standards for processing under the following circumstances as shown in paragraphs (1)-(3) of this subsection. (1) The physical media and labeling do not conform to the specifications in sec.1301.14 of this title (relating to Instructions for Filing Discharge Reports). (2) The physical media are unreadable due to physical damage. (3) The file structure does not conform to the specifications in sec.1301.19 of this title (relating to Discharge Reports-Records, Data Fields and Codes). (c) Correction of Errors. (1) The executive director shall review all discharge reports accepted for processing and will process all discharge files against the editing criteria established by the this section and by the executive director. Within 30 days of receipt of an accepted discharge report the executive director shall notify the hospital in detail of all errors detected in the discharge report. (2) Within 30 days of receiving initial notice of errors in a discharge report, the hospital shall correct all discharge files containing errors, add any discharge files determined to be missing from the initial discharge report and resubmit the discharge files. If the hospital disagrees with any identified error, the hospital shall submit written justification of the correctness or completeness of its data. Each hospital shall submit such modified and/or additional discharge files as may be required to allow the chief executive officer or the chief executive officer's agent to certify the discharge report as required by sec.1301.17 of this title (relating to Certification of Discharge Reports). Corrections to a discharge report shall be submitted in the same medium and format as the original discharge report unless the executive director approves another medium. (3) Within ten days of receiving corrections to a discharge report from a hospital, the executive director shall notify the hospital of any remaining errors. The hospital shall have ten days from receipt of this notice to correct the errors noted or submit a written explanation of why the data should be deemed correct and complete. This process shall be repeated until the executive director is satisfied that the data submitted by the hospital is substantially accurate and until the hospital is able to certify the discharge report as required by sec.1301.17 of this title (relating to Certification of Discharge Reports). (d) The executive director will document and the Council will approve all acceptance and editing criteria utilized in reviewing discharge reports. If acceptance and editing criteria are incorporated into computer software, and if the software is the property of the Council, the executive director will make copies of the portions of the software containing the criteria available on paper or magnetic media. The executive director shall make this information available to submitters without charge and to others for the cost of reproduction. (e) Failure to correct a discharge report which has been filed but contains errors or omissions within the due dates in sec.1301.13 of this title (relating to Schedule for Filing Discharge Reports) is punishable by a civil penalty pursuant to Health and Safety Code, sec.108.014. sec.1301.17. Certification of Discharge Reports. (a) Within 120 days after the end of each reporting quarter the executive director shall compile an electronic data file for each reporting hospital using all discharge files received from each hospital. The file shall have one record for each patient discharged during the reporting quarter and one record for any patient discharged during a previous reporting quarter for whom additional discharge files have been received. This file will include all data submitted by the hospital which the executive director intends to use in the creation of the public use data file. The data file will provide physicians and other health professionals the opportunity to review, request correction of, and comment on records of patients for whom they are shown as admitting or treating. The executive director shall determine the format and medium in which the quarterly file will be delivered to hospitals. (b) The chief executive officer of each hospital shall certify that the discharge report for each quarter is accurate using forms supplied by the Council. The certification form may be signed by a person designated by the chief executive officer and acting as the officer's agent. Designation of an agent does not relieve the chief executive officer of personal responsibility for the certification. If the chief executive officer does not believe the quarterly file is accurate, the officer shall provide the executive director with detailed comments and data necessary to correct any inaccuracy and certify the file subject to those corrections being made. (c) The certification shall represent that a complete review of hospital records was accomplished to assure the accuracy of the discharge report and any corrections submitted, that all errors and omissions known to the hospital have been corrected, and that to the best of their knowledge and belief, the data submitted is accurate and complete. The certification shall also represent that the hospital has provided physicians and other health professionals on its medical staff a reasonable opportunity to review the discharge files for which they were the admitting or treating physician or other health professional prior to certification, have corrected any errors brought to the hospital's attention and have included with the discharge report any comments on the accuracy of the data submitted by physicians or other health professionals. Written explanation of any unresolved disagreements with the executive director concerning the accuracy and completeness of the data at the time of the certification shall be attached to the certification form. (d) Each hospital must file its certification of each quarter's data with the Council within six months following the last day of the reporting quarter. Extensions to this period will not be granted. (e) Failure to timely file a certification of discharge data previously submitted is punishable by a civil penalty pursuant to Health and Safety Code, sec.108.014. sec.1301.18.Hospital Discharge Data Release. (a) Council records are public records under Government Code, Chapter 552, except as specifically exempted by Health and Safety Code, sec.108.010 and sec.108.013, and are available for public inspection during normal business hours. Copies of such records may be obtained upon request and upon payment of user fees established by the Council. Discharge files in the original format as submitted to the Council are exempt from disclosure pursuant to Health and Safety Code, sec.108.010 and sec.108.013, and shall not be released. Likewise, patient specific data collected by the Council through audits of hospital data shall not be released. (b) Creation of public use data file. The executive director will create a public use data file by creating a single record for each inpatient discharge and adding, modifying or deleting data elements in the following manner as listed in paragraphs (1)-(10) of this subsection: (1) convert patient birth date to age; (2) convert admission and discharge dates to a length of stay measured in days and a code for the day of the week of the admission; (3) convert procedure and occurrence dates to day of stay values; (4) delete physician and other health professional names and numbers: assign uniform identifiers; (5) convert payer names and identification numbers to uniform payer identifiers: assign codes indicating the primary source of payment; (6) convert employer name and address data to a Standard Industrial Classification Code; (7) convert facility name, address and identification numbers to a facility identifier; (8) convert all procedure codes to ICD-9-CM; (9) add risk and severity adjustment scores utilizing an algorithm approved by the Council; (10) add indicators of whether the hospital is a children's specialty hospital and whether the hospital is a teaching hospital. (c) Release of files and statistical compilations based on the public use data file. The Council shall promptly provide data to those requesting it, subject to restrictions imposed by Health and Safety Code, sec.108.010 and sec.108.013 as interpreted by the Council's rules. (1) The executive director will make available a public use data file on magnetic media for each quarter not later than seven months after the end of the quarter. (A) The executive director shall release public use data from hospitals that have certified the data as required by sec.1301.17 of this title (relating to Certification of Discharge Reports). A hospital's failure to execute the certification form after six months shall not prevent the executive director from releasing the hospital's data if the director believes the data submitted is reasonably accurate and complete. The executive director shall not include in the public use data file records derived from hospital discharge files which contain material errors. The executive director will include with the public use data file information on the number of discharge files received from each hospital and the number of discharge files from each hospital included on the public use data file. (B) If additional discharge files become available after the initial release of the public use data file for any quarter, the executive director will add these records to the public use data file and make the additional records available to the public. (C) The other sections of these rules not withstanding, the executive director shall not create a public use data file from the discharge reports covering discharges occurring in the first quarter of 1998. It is the intent of the Council to utilize this data only for testing and calibration of its data processing systems and to allow hospitals the opportunity to test and calibrate their own data reporting systems. (D) The other sections of these rules not withstanding, the executive director shall not create or release a public use data file from discharge reports covering discharges for the second quarter of 1998 until a public use data file covering discharges for the third quarter of 1998 is created and released. The Council will initially release six months of data in order to provide a more reliable body of data for analysis and decision-making and to make available public use data files on a quarterly schedule thereafter. (2) The Council shall not charge Texas state agencies a fee for data requested solely for the internal use of the agency to comply with Health and Safety Code, sec.108.012(b). Prior to filling the request of a state agency without fee, the executive director shall secure an interagency agreement imposing restrictions on distribution, republication or reuse of the data in ways that would diminish user fees to the Council. (3) The executive director shall establish procedures for screening all requests to assure that filling the request will not violate the provisions of Health and Safety Code, sec.108.013(c). (d) The data elements specified for discharge reports in sec.1301.19 of this title (relating to Discharge Reports-Records, Data Fields and Codes) do not constitute "Provider Quality Data" as discussed in Health and Safety Code, sec.108.010. Statistical compilations compiled from public use data files may be released with or without either discharge-specific or aggregate provider quality data. Statistical compilations without provider quality data are not subject to the restrictions imposed on the Council by Health and Safety Code, sec.108.010. Public use data files and statistical compilations compiled from public use data files with provider quality data may only be released subject to the restrictions in Health and Safety Code, sec.108.010, and rules adopted by the Council to implement this section of the statute. (e) A public use data file or a statistical compilation compiled from public use data files which is specified by the requestor shall not be considered a "report issued by the Council" as referenced in Health and Safety Code, sec.108.011(f). (f) Requests for data files and statistical compilations based on public use data files including data on one or more provider are matters of public record and copies of all requests shall be maintained by the Council for two years from the date of receipt. The executive director will transmit monthly a summary of all requests received to all hospitals submitting discharge data to comply with Health and Safety Code, sec.108.011(e). (g) With any public use data file or any statistical compilation prepared by the Council, the executive director shall attach all comments submitted by providers which relate to any data included in the file or compilation. sec.1301.19.Discharge Reports-Records, Data Fields and Codes. (a) Discharge reports shall be submitted electronically in the national standard flat file format for inpatient hospital bills defined by the United States Department of Health and Human Services, Health Care Finance Administration (HCFA); commonly known as the HCFA UB-92 Electronic Format (Versions 004.1 and 004.0). HCFA updates this format from time to time by issuing new versions. The Council will accept discharge reports in the latest version or in the immediately preceding version. At the effective date of these rules, the latest version was version 004.1 and the immediately preceding version was version 004.0. The Council will make detailed specifications for these formats available to submitters and to the public. (b) Except as otherwise provided in this section, discharge reports shall be submitted using the national uniform billing data element specifications as developed by the National Uniform Billing Committee (NUBC) as published by the State Uniform Billing Committee (SUBC) with instructions specific to Texas third party fiscal intermediaries in the Texas UB-92 Manual. The NUBC revises these data element specifications from time to time and the SUBC publishes revisions showing the effective date for changes to each data element. Hospitals shall submit discharge reports using the data element specifications in effect as of the date of the discharge. The Council will make detailed specifications for these data elements available to submitters and to the public. (c) In addition to the data elements contained in the Texas UB-92 Manual, the Council has defined the following data elements shown is in this subsection and has defined the location in the HCFA UB-92 Electronic Format (Versions 004.1 and 004.0) where each element is to be reported. (1) Source of Payment Code-This data element shall be reported at Record 30, Field 04, Beginning Position 25 as an alphanumeric value. Acceptable codes are: _ = Charity/Self pay _ = Workmen's Compensation _ = Medicare _ = Medicaid _ = Other Federal Programs (includes Veterans Administration) _ = Commercial _ = Blue Cross _ = Champus _ = Other _ = State or Local Government Programs _ = Commercial PPO _ = Medicare Managed Care _ = Medicaid Managed Care _ = Commercial HMO (2) Submission Purpose Code-This data element shall be reported at Record 01, Field 20.8, Beginning Position 183 As an alphanumeric value. Acceptable codes are C = Claim, D = Discharge Statement, and B = Both. This code is required if a hospital bill clearinghouse is utilized in the data collection effort. (d) Data may be numeric or alphanumeric. All numeric data shall be right justified and zero-filled. All alphanumeric data shall be left justified. The length of all records is 192 characters. Conditional data fields shall be filled with spaces when other data is not present. (e) Hospitals shall submit the required minimum data set for all patients for which a discharge file is required by this title. For patients with any form of insurance, hospitals shall submit to the Council all data elements submitted to any third party payer in addition to data elements in the required minimum data set. The required minimum data set includes the following data elements as listed in paragraphs (1)-(40) of this subsection: (1) Patient control number; (2) Patient last name; (3) Patient first name; (4) Patient middle initial; (5) Patient sex; (6) Patient birth date; (7) Type of admission; (8) Source of admission; (9) Source of Payment Code; (10) Patient city; (11) Patient state; (12) Patient zip; (13) Admission/start of care date; (14) Statement covers period from; (15) Statement covers period through; (16) Patient status; (17) Medical record number; (18) Type of bill; (19) Accommodations revenue codes (all applicable); (20) Accommodations rates (all applicable); (21) Accommodation days (all applicable); (22) Accommodation total charges (all applicable); (23) Inpatient ancillary revenue code (all applicable); (24) Units of service (all applicable); (25) Ancillary charges total (all applicable); (26) Principal diagnosis code; (27) Other diagnosis codes (all applicable); (28) Principal surgical procedure code (if applicable); (29) Principal surgical procedure date (if applicable); (30) Other surgical procedure codes (all applicable); (31) Other surgical procedure dates (all applicable); (32) Admitting diagnosis; (33) External cause of injury (if applicable); (34) Procedure coding method used; (35) Attending physician number; (36) Operating or other physician number (if applicable); (37) Other physician number (all applicable); (38) Attending physician name; (39) Operating or other physician name (if applicable); (40) Other physician name (all applicable); (f) A submission will consist of a set of the following types of records from the HCFA UB-92 Electronic Format (Versions 004.1 and 004.0) specification as shown in paragraphs (1)-(13) of this subsection. (1) Processor Label Data (Record 01). Files will be formatted so that this is a data record, not a conventional label. From a system standpoint, this will be a "labelless" file. This record will be the first record in the file. (2) Provider Data (Record 10). The provider's batch record describes the types of claims submitted for a specific provider. Field 02 of this record identifies the specific type of claim. A provider may be authorized to submit more than one claim type. In that case, more than one batch will be required to identify each claim type. Each claim in the batch will be edited for claim type. Record 40, Field 04 identifies claim type and will be matched to the batch record for claim type. Each batch record must be followed by claim records and then Provider Batch Control Record (Record 95). This record is required at the beginning of each batch. (3) Patient Data (Record 20). The patient record is the first record of a claim. It is required for all claim types as it contains the patient's demographic data. (4) Third Party Payer Data (Record 30). The third party payer record identifies the insurance information for each payer. If the patient has other insurance, two or more records must be submitted, one for each carrier. If the patient has no third party payer, submit one Record 30 with Field 04 = A. NOTE: Records must be in the correct payer priority sequence. The '01' Record determines which source payment code will be considered as primary. (5) Claim Data (Record 40). The claim data record identifies miscellaneous data needed to process a claim. (6) Claim Data Conditions and Values (Record 41). This record is used to report condition and value codes. If none are needed, this record is not necessary. (7) Inpatient Accommodations (Record 50). This record identifies the room charges (revenue codes 100-219) for an inpatient claim. (8) Inpatient Ancillary Services (Record 60). This record identifies the inpatient ancillary services (revenue codes 220-999). Revenue code '001' (total) is required for all lines of business. It must be the last revenue code listed and must contain the correct totals. (9) Medical Data (Record 70). This record identifies the diagnosis and surgical procedure code requirements. (10) Physician Data (Record 80). This record is for the physician license number and name. (11) Discharge Totals (Record 90). This record is the final record for each discharge and is required for all discharge types. The record count and charges associated with the discharges will be edited to this record. The discharge will be rejected when the counts or totals do not agree to those accumulated while processing the individual records of each discharge. If a record is not submitted for a discharge, enter '0' for that record count. (12) Provider Batch Control (Record 95). The provider's batch control record contains information for all the claims of a specific claim type. The system will accumulate totals as it processes each claim. The totals are then edited to the batch totals record. When the totals are out of balance, the batch will be rejected. (13) File Control Totals (Record 99). The processor's file control record contains control information for all the claims in the file. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on July 30, 1997. TRD-9709885 Jim Loyd Director of Program Planning Texas Health Care Information Council Effective date: August 19, 1997 Proposal publication date: February 11, 1997 For further information, please call: (512) 424-6492 TITLE 34. PUBLIC FINANCE PART I. Comptroller of Public Accounts CHAPTER 3. Tax Administration SUBCHAPTER O. State Sales and Use Tax 34 TAC sec.3.294 The Comptroller of Public Accounts adopts an amendment to sec.3.294, concerning the rental and lease of tangible personal property, with changes to the proposed text as published in the March 25, 1997, issue of the Texas Register (22 TexReg 3030). The Tax Code, sec.151.006 and sec.151.152, was amended by Senate Bill 982, 74th Legislature, 1995, effective September 1, 1995, to exempt sales for resale in Mexico. The amendment provides information concerning the acceptance of valid and properly completed resale certificates from Mexican retailers. The amendment also clarifies policy regarding the sale for resale exemption under Tax Code, Chapter 151, for accessories and equipment attached to motor vehicles that are held for sale, lease, or rental. In addition, a change was made to the proposed text of subsection (c)(3)(B) to correct the reference to subsection (i). The correct reference is to subsection (j) of this section. No comments were received regarding adoption of the amendment. This amendment is adopted under the Tax Code, sec.111.002, which provides the comptroller with the authority to prescribe, adopt, and enforce rules relating to the administration and enforcement of the provisions of the Tax Code, Title 2. The amendment implements the Tax Code, sec.sec.151.006, 151.152, and 151.302. sec.3.294. Rental and Lease of Tangible Personal Property. (a) Definitions. The following words and terms, when used in this section, shall have the following meanings, unless the context clearly indicates otherwise. (1) Financing lease. (A) A written lease contract containing either of the following provisions or conditions at the inception of the contract: (i) title to the property must be transferred to the lessee at the end of the lease; or (ii) an option to purchase the property at a nominal price is available to the lessee at the end of the lease (a price is nominal which is, at the time the contract is executed, estimated to be less than 10% of the fair market value of the property at the time the option is to be exercised). (B) A written lease contract containing either of the following provisions or conditions at the inception of the contract will be presumed to be a financing lease: (i) the lease term is equal to 75% or more of the estimated economic life of the property and the contract makes no provisions for the return of the property to the lessor. For used property, this section does not apply if the beginning of the lease term falls within the last 25% of the total estimated economic life of the lease property; or (ii) the residual value of the leased property is less than 10% of the property's fair market value at the inception of the lease and the contract makes no provisions for the return of the property to the lessor. (C) The presumption outlined in subparagraph (B) of this paragraph that the contract is a financing lease may be rebutted by showing that the contract is not merely a security device, that the property will be usable for its intended purpose at the end of the lease term, and that the lessor in good faith intends to reclaim possession of the property at the end of the lease term or to sell the property at the fair market value or to lease it for its fair market rental value. (2) Lease or rental - A transaction, by whatever name called, in which possession but not title to tangible personal property is transferred for a consideration. In this section, the words lease and rental are used interchangeably. (3) Operator - A person who actively guides, drives, pilots, or steers tangible personal property. A person who provides maintenance, repair, or supervision only is not an operator for the purposes of this section. (4) Operating lease - A lease contract which gives the lessee use of the leased property for a certain period. For the purposes of the sales and use taxes, a written contract in the legal form of a lease will be treated as an operating lease unless it meets the definition of a financing lease. All oral leases will be treated as operating leases. (b) Leases. Tax must be collected from the lessee on all charges contained in the lease unless the charge is separately stated and is nontaxable as provided by this section. See subsection (f) of this section for imposition of tax and time for reporting. (c) Tangible personal property leased with and without an operator. (1) Receipts from the lease of tangible personal property without an operator are taxable. (2) The furnishing of tangible personal property with an operator for which a single charge is made to the customer shall be presumed to be the performance of a service and no tax may be charged to the customer, unless the service is taxable under other provisions of the Tax Code, Chapter 151. Sales or use taxes will be due on the original purchase price of the tangible personal property. (A) The presumption set forth in subsection (c)(2) of this section may not be rebutted solely by one party to the transaction. The presumption may be rebutted by the following criteria which establish a lease of tangible personal property: (i) the customer exercised direct control or supervision over the operator of the tangible personal property; and (ii) the intent of the agreement was to lease a piece of tangible personal property and separately furnish an operator. (B) If it is established that a lessor who made a single charge to customers did in fact make a lease of tangible personal property, the tax will be due on the fair market rental value of the tangible personal property. If this cannot be determined, the tax will be due on the total charge reduced by the charge attributable to the operator determined from lessor's records. If the charge for the operator cannot be determined from the lessor's records or if it seems unreasonable, the comptroller will make a determination of a reasonable operator charge. (3) A transaction in which tangible personal property is furnished with an operator, and the customer is charged separately for tangible personal property and operator, shall be presumed to be the lease of tangible personal property and the separate furnishing of an operator; the receipts from the separate charge for the tangible personal property are taxable. The separate charge for the operator will not be taxable unless a taxable service is being provided. (A) If a nontaxable service is being provided and it is established that the separate charge for the lease of tangible personal property is lower than the tangible personal property's fair market rental value, sales tax will be assessed on the fair market rental value unless the lessor presents convincing evidence to the comptroller as to why the rental charge should be lower than fair market rental value. (B) If it is established that a lessor who separated charges for tangible personal property and operator nevertheless used the tangible personal property to perform a service, sales tax will be assessed on the fair market rental value if the property was purchased under a valid resale certificate. See subsection (j) of this section. (d) Other charges related to lease agreements. Operating and financing lease agreements and related billings may contain a variety of charges in addition to the basic rental/lease charges, including charges that occur subsequent to the rental. All charges related to a lease agreement are taxable unless excluded from tax by this section. Some of these charges and their tax consequences are as follows. (1) Separately stated charges for labor or services rendered in installing, applying, remodeling, servicing, maintaining, or repairing the item being leased are subject to tax. (2) Damage waiver fees are subject to tax. A charge after the rental for repair to the damaged rental item is subject to tax as a taxable service. See sec.3.292 of this title (relating to Repair, Remodeling, Maintenance, and Restoration of Tangible Personal Property). Charges for items destroyed or lost by a lessee are not taxable. However, if a lessee is required to purchase an item damaged by the lessee, the charge for the damaged item is taxable. (3) All transportation charges billed by the lessor to the lessee related to the leased property are taxable. Charges for transportation billed directly to the lessee by third-party carriers are not taxable. See sec.3.303 of this title (relating to Transportation and Delivery Charges). (4) Charges in the lease agreement for labor, such as charges for supervision, set-up, hook-up, assembly or disassembly, erection, and dismantling, are included in the lease price and are taxable. (5) A charge imposed for the early termination of the lease is included in the lease price and is taxable. (6) Under an operating lease, any interest charges will be taxable whether or not separately stated unless the interest charge is clearly imposed for late payment or other defaults under the lease. (7) Under a financing lease, charges for interest by the lessor to the lessee will be taxable unless the rate of interest or the actual interest charged is separately stated in a contract, invoice, billing, sales slip, or ticket to the customer. (e) Tangible personal property rented for use on residential and nonresidential jobs. (1) Persons renting equipment for use in the performance of contracts to construct new nonresidential real property or to construct, repair, or remodel residential real property owe tax to the equipment rental company. Tax may not be collected from their customers on a separately stated charge for this reimbursable expense item even if the equipment charges to the customer are separately stated from operator charges. See sec.3.291 of this title (relating to Contractors). (2) Persons renting equipment for use in the performance of contracts to repair or remodel nonresidential real property owe tax to the equipment rental company. Tax must also be collected from their customers on the total charge for the job including the amount paid for the equipment rental. (3) When both remodeling and new construction are being performed under the same contract, the tax to be collected from customers on the rental charges should be determined as provided by sec.3.357(b)(7) of this title (relating to Labor Relating to Nonresidential Real Property Repair, Remodeling, Restoration, Maintenance, New Construction, and Residential Property). (f) Imposition of taxes; time for filing; credits. (1) Leases subject to sales tax. (A) An operating lease executed while the property is within the state is subject to sales tax. Tax will be due on the total lease amount for the entire term of the lease regardless of where the property is used if the lessee takes delivery in the state. Any renewal of the contract, extensions, or options exercised while the tangible personal property is outside the state will not be subject to Texas tax unless the property reenters the state. (B) A financing lease executed while the property is within the state is subject to sales tax if the lessee takes delivery in the state. Tax will be due on the total amount of the contract regardless of where the property received in Texas is used during the lease. (2) Leases subject to use tax. Property brought or shipped into the state for use under the terms of a financing lease or an operating lease will be presumed to be subject to use tax. See sec.3.346 of this title (relating to Use Tax). The use tax will be due on the lease price for the entire term of an operating lease regardless of where the initial contract was executed. Credit will be allowed against any sales or use tax legally imposed and paid to another state. See sec.3.338 of this title (relating to Multistate Tax Credits and Allowance of Credit for Tax Paid to Suppliers). (3) Method and time for filing reports. (A) Under an operating lease, a lessor must report the rental charges in the period in which they are considered income under the lessor's method of reporting. Under the accrual method of reporting, the rental charges are considered income when the lease amount becomes due under the rental agreement. If the lessor does not collect the tax, the lessee must report the tax in the period in which each lease amount becomes due under the rental agreement. (B) Under a financing lease, the lessor must collect all tax due under the lease at the time the lessee takes possession of the property or when first payment is due from the lessee, whichever is earlier. Tax must be reported on or before the 20th day of the month following the reporting period in which the tax is collected. If the lessor does not collect the tax, the lessee must report the tax due when the lessee takes possession of the property or when first payment is due, whichever is earlier. (C) An out-of-state lessor deriving rental receipts from tangible personal property located in Texas is engaged in business in Texas and is required to collect Texas use tax. Under an operating lease, the use tax must be reported by the lessee if the lessor fails to collect it. The tax must be reported by the lessee based upon the lessee's accounting method used for regular books and records. Under a financing lease, the use tax must be reported by the lessee when the lessee takes possession of the property or when the first payment is due, whichever is earlier. (g) Sales of leased property under operating leases; credit allowed. (1) When a lessee buys the property that the lessee was renting under the terms of an operating lease and the lessor allows credit against the sales price for all or part of the lease payments previously made by the lessee on the same property, tax is not due on the amount allowed as credit if the lessor has collected and remitted tax on the prior rental payments. The lessor must collect the tax on the balance of the sales price based on its method of accounting for sales and use tax purposes. (2) When the lessor sells property to a third party who was not the lessee of that property and allows the third party credit against the sales price for all or part of the lease payments previously made by the former lessee, tax may not be refunded on the amount allowed as credit. The lessor must also collect and report the tax on the sales price of the property to the third party based on its method of accounting for sales and use tax purposes. (h) Assignment of lease payments under operating leases. A lessor may factor or assign to a third party the lessor's right to receive all lease payments due under the agreement with the lessee. At the time the lease agreement is factored or assigned, tax is due on all lease amounts not yet reported. The lessor is responsible for reporting the tax to the comptroller's department in the report period the lease agreement is assigned or factored. No deduction in the amount of tax due and payable by the lessor is allowed if a transfer at a discount is made to a third party. No tax liability is incurred by the purchaser of the lease agreement. This section does not apply to the pledge of lease contracts by a lessor to a third party as loan collateral under the terms of a bona fide loan agreement. (i) Assignment of lease payments and property under operating leases. A lessor may assign to a third party the lessor's right to receive all lease payments due under an agreement with the lessee and, in the same transaction, transfer title to the property covered by the lease. At the time the operating lease contract is assigned and title to the property is transferred to the third party, the third party purchaser must begin collecting and remitting tax on the full amount of the taxable rental charges remaining in the lease. The third party purchaser may issue a resale certificate to the lessor as provided by subsection (j) of this section. Tax must be reported by the third party purchaser as provided by subsection (f)(3)(A) of this section. (j) Sales for resale; resale certificates. (1) The purchaser of property which is to be held for lease within the United States of America, its territories and possessions, or within the United Mexican States may issue a resale certificate in lieu of the sales or use tax at the time of purchase. Mexican retailers who purchase for resale must show their Federal Taxpayers Registry (RFC) identification number for Mexico on the resale certificate and give a copy of their Mexican Registration Form to the Texas seller. However, if the lessor subsequently uses the property in any manner other than the leasing of it, or display or demonstration of it, the lessor becomes liable at the time of the use for sales tax based on the fair market rental value for the period of time used. The fair market rental value is the amount that a lessee would pay on the open market to rent the item for use. If the fair market rental value of the property cannot be ascertained, tax is due on the original purchase price of the property. (2) At any time, the lessor using the property purchased under a resale certificate may stop paying tax on the fair market rental value and instead pay sales tax on the original purchase price. When the lessor elects to pay sales tax on the purchase price, credit will not be allowed for taxes previously paid on the fair market rental value. See sec.3.285 of this title (relating to Resale Certificate; Sales for Resale). (3) A resale certificate may be issued by a retailer for a repair or replacement part, accessory, or equipment that will be attached to a motor vehicle to be rented or leased under the provisions of the Tax Code, Chapter 152. In this paragraph, the terms "rental" and "lease" are defined by the Tax Code, Chapter 152, rather than by subsection (a)(2) of this section. (k) Lease of real property with tangible personal property. (1) If a contract for the lease or rental of real property includes the lease or rental of tangible personal property (such as furniture) as part of the agreement, no sales tax is due on the amount charged the tenant for the lease or rental of the tangible personal property. A resale certificate may not be issued and sales or use tax must be paid at the time the tangible personal property is purchased. (2) Sales or use tax is due on the separate lease or rental of tangible personal property by a person or entity not owning or managing the real property in which the tangible personal property is or will be situated. A resale certificate may be issued in lieu of paying the tax at the time of purchase of the tangible personal property for subsequent lease or rental. (l) Other taxes. For information pertaining to tax on motor vehicle rental receipts, refer to sections promulgated under the Motor Vehicle Sales and Use Tax Act. (m) Local tax. For proper collection and allocation of city and transit sales taxes, see sec.3.374 of this title (relating to Collection and Allocation of the City Sales Tax) and sec.3.424 of this title (relating to Collection and Allocation of Transit Sales Tax). This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on August 1, 1997. TRD-9710025 Martin Cherry Chief, General Law Comptroller of Public Accounts Effective date: April 21, 1997 Proposal publication date: March 25, 1997 For further information, please call: (512) 463-3699 TITLE 43. TRANSPORTATION PART I. Texas Department of Transportation CHAPTER 1. Management SUBCHAPTER F. Advisory Committees 43 TAC sec.sec.1.82, 1.83, 1.85 The Texas Department of Transportation adopts amendments to sec.1.82, sec.1.83, and sec.1.85, concerning statutory and department advisory committees. Section 1.85 is adopted with changes to the proposed text as published in the June 10, 1997, issue of the Texas Register (21 TexReg 5657). Section 1.82 and section 1.83 are adopted without changes and will not be republished. Texas Civil Statutes, Article 6252-33, provides that a state agency which is advised by an advisory committee shall adopt rules that state the purpose of the committee and describe the task of the committee and the manner in which the committee will report to the agency. Texas Civil Statutes, Article 6252-33, further provides that a state agency shall establish by rule a date on which the committee will automatically be abolished unless the governing body of the agency affirmatively votes to continue the committee in existence. House Bill 1418, 75th Legislature, 1997, requires the creation of a Household Goods Carrier Advisory Committee to provide a forum for household goods carriers and the general public to make recommendations on modernizing and streamlining the rules to effect an efficient registration process for businesses and individuals, conduct a study of the feasibility and necessity of requiring any vehicle liability insurance for household goods carriers required to register under Texas Civil Statutes, Article 6675c, sec.8, and recommend a maximum level of liability for loss or damage of motor carriers. In accordance with House Bill 1418, amendments to sec.1.82 and sec.1.83 are proposed to create the Household Goods Carrier Advisory Committee. Section 1.83 and sec.1.85 presently mandate that the department's statutory and department advisory committees shall be abolished on September 1, 1997, unless continued in existence by affirmative vote of the commission. These sections are amended to reflect the department advisory committees will continue in existence until September 1, 1999, and the statutory advisory committees will continue until September 1, 2001. The amendments to sec.1.83 authorize the Public Transportation Committee to create issue subcommittees and continue the following statutory advisory committees: Aviation Advisory Committee, Public Transportation Advisory Committee, and Vehicle Storage Facility/Tow Truck Rules Advisory Committee. To comply with Texas Civil Statutes, Article 6252-33, sec.1.85 has various proposed amendments. One proposed amendment to sec.1.85 abolishes the Registration and Title System Liaison Committee and Dealer Advisory Board, County Tax Assessor-Collector Review Team, El Paso District Citizen's Advisory Committee, Hydraulics and Erosion Control Laboratory Industry Advisory Committee, Transportation Systems Efficiency Advisory Committee, and Transit Operators' Advisory Committee because these committees have fulfilled their mission. The amendment also abolishes the Consultant Engineering Advisory Committee, Quality Control/Quality Assurance Specification Development Committee, and the Quality Control/Quality Assurance Certification Advisory Committee because these committees merely exchange information and do not advise the department. Another amendment to sec.1.85 changes the names of the Tow Truck Rules Advisory Committee to the Vehicle Storage Facility/Tow Truck Rules Advisory Committee, the Local Intelligent Vehicle Highway Systems (IVHS) Steering Committee to Intelligent Transportation Systems Steering Committee, and the Safety Management System to the Partners in Texas Transportation Safety Committee to more accurately reflect the tasks of the committees. An additional amendment to sec.1.85 also continues the Bicycle Advisory Committee, Intelligent Transportation Systems Committee, Motor Transportation Advisory Committee, Partners in Texas Transportation Safety Committee, Statewide Transportation Policy Committee, and Traffic Records Council. The amendments were published in the June 10, 1997, issue of the Texas Register (22 TexReg 5657) and comments were received from the Comptroller of Public Accounts, Central Transportation Systems, and Southwest Movers Association. Central Transportation Systems, and Southwest Movers Association suggested that due to the size of the industry, the Household Goods Carriers Committee created by sec.1.82(b)(2) should not be limited to three carrier members. They recommended that the advisory committee be composed of three household goods motor carriers for each of the equipment size categories. Texas Civil Statutes, Article 6252-33, provides that an advisory committee must be composed of a reasonable number of members not to exceed 24 members. The committee must also have a balanced representation between the industry regulated and the consumers of services of that industry. To add six additional motor carriers to the committee would necessitate an increase in the numbers of consumers on the committee as well. It would be difficult to coordinate meetings and actions for a committee that large. If, at a future date, the department determines that more input is necessary, it will consider adding additional members. Therefore, no changes will be made concerning this comment. The Comptroller of Public Accounts commented on sec.1.85(a)(2)(E) and (8)(E), concerning the reimbursement of expenses for the Statewide Transportation Policy Committee and the Bicycle Advisory Committee. The commenter questioned whether the members of the Statewide Transportation Policy Committee are entitled to receive travel expenses. Since the General Appropriations Act for fiscal years 1998 and 1999 did not specifically authorize reimbursement for this committee, the department has deleted the reimbursement provision from 1.85(a)(2)(E). The commenter also stated that it was unaware of any statute that authorized the department to establish and continue the Bicycle Advisory Committee. In addition to authority under Transportation Code, sec.201.101, sec.201.103, and sec.201.601, Transportation Code sec.202.902 mandates that the commission adopt bicycle rules. The rules must include the specific duties of a statewide bicycle coordinator. One of the bicycle coordinator's duties is to obtain comments from bicyclists on department policies affecting bicycle use of state highways. The commission has created the committee under the broad authority of this statute to obtain those comments. The legislature has recognized the legitimacy of the committee by appropriating funds for its expenses in Article VII, sec.32 of the General Appropriations Act, 74th Legislature, 1997. The amendments are adopted under Transportation Code, sec.201.101, which provides the Texas Transportation Commission with the authority to establish rules for the conduct of the work of the Texas Department of Transportation, and Texas Civil Statutes, Article 6252-33 which requires a state agency to adopt rules that state the purpose and task of the committees. sec.1.85. Department Advisory Committees. (a) Creation. (1) Project advisory committees. (A) Purpose. The executive director may authorize a district engineer to create, by written order, an ad hoc project advisory committee composed of the following members as may be deemed appropriate by the district engineer: department staff; affected property owners and business establishments; technical experts; professional consultants representing the department; and representatives of local governmental entities, the general public, chambers of commerce, and the environmental community. A project advisory committee shall serve the purpose of facilitating, evaluating, and achieving support and consensus from the affected community and governmental entities in the initial stages of a highway improvement project. Advice and recommendations of a committee provide the department with an enhanced understanding of public, business, and private concerns about a project from the development phase through the implementation phase, thus facilitating the department's communications and traffic management objectives, resulting in a greater cooperation between the department and all affected parties during project development and construction. (B) Duties. A project advisory committee shall: (i) maintain community and local government communication; and (ii) respond in a timely fashion to affected parties' concerns about project development and construction. (C) Manner of reporting. A project advisory committee shall report its advice and recommendations to the district engineer. (D) Duration. A project advisory committee may be abolished at any stage of project development, but in no event may a committee continue beyond completion of the project. (2) Statewide Transportation Policy Committee. (A) Purpose. Transportation Code, sec.201.601, and 23 United States Code sec.135 require the department to develop a statewide multimodal transportation plan that encompasses all modes of transportation. Federal law further provides that in developing the plan the department must seek public input from interested parties. To comply with these requirements, the Statewide Transportation Policy Committee, to be composed of private transportation providers and other governmental agencies and individuals concerned with transportation, will advise the department on its statewide transportation plan. The committee will provide a forum for identifying issues to be addressed by the planning process and for providing input into the department's planning process. The committee members represent a constituency of interests and in this way broaden input into the planning process. (B) Duties. The committee shall: (i) review and comment on issue papers prepared as part of developing recommended goals for Texas' transportation system; (ii) review and comment on the draft statewide transportation plan; (iii) have its members serve as chairs of issue committees to develop and explore issues that pertain to the statewide transportation planning process; and (iv) provide logistical assistance such as furnishing data and existing planning materials. (C) Manner of reporting. The committee shall report its advice and recommendations to the commission. (D) Statewide transportation policy issue committees. (i) The Statewide Transportation Policy Committee may appoint one or more issue committees to advise it on specific planning issues, such as environmental, intermodal, financial, and special transportation needs. (ii) An issue committee shall report its advice and recommendations to the Statewide Transportation Policy Committee. (3) Ad hoc transit advisory panels. (A) Purpose. In order to provide for effective and timely input from affected public transportation providers and riders, the commission, by minute order, may create an ad hoc transit advisory panel. (B) Duties. An ad hoc advisory panel shall advise the Public Transportation Division on a single issue or program that only affects a specific segment of the public transportation industry or of the public. An example of an ad hoc panel would be a committee created to advise the division on the funding allocation rules for a particular grant program. (C) Manner of reporting. An ad hoc advisory panel shall report its advice and recommendations to the Public Transportation Division director. (D) Duration. An ad hoc advisory panel shall be abolished no later than 90 days after its creation. (4) Rulemaking advisory committees. (A) Purpose. The commission, by order, may create ad hoc rulemaking advisory committees pursuant to the Government Code, Chapter 2001, sec.2001.031, for the purpose of receiving advice from experts, interested persons, or the general public with respect to contemplated rulemaking. (B) Duties. A rulemaking advisory committee shall provide advice and recommendations with respect to a specific contemplated rulemaking. (C) Manner of reporting. A rulemaking advisory committee shall report its advice and recommendations to the division responsible for the development of the rules. (D) Duration. A rulemaking committee shall be abolished upon final adoption of rules by the commission. (5) Traffic Records Council (TRC). (A) Purpose. The TRC coordinates and guides the planning and implementation of various Texas traffic records systems. The overall goal of the TRC is to share information regarding the various state data bases related to traffic records, establish a mutual understanding of the overall state goal of increasing the safety and efficiency of the roadway system, and to develop strategies for continued cooperation among all state and local participants with an interest in the traffic records process. (B) Duties. The TRC shall: (i) assist the department in the coordination and guidance of the planning and implementation of the various Texas traffic records systems to improve information quality and quantity; (ii) provide recommendations concerning the implementation of a strategic plan for the improvement of the state's record systems; (iii) help transfer related information on technology and systems through meetings and forums; and (iv) provide recommendations to the various agencies on system enhancements and linkages. (C) Manner of reporting. The TRC shall report its advice and recommendations to the various participating agencies, including the department and its Traffic Operations Division. (6) Intelligent Transportation Systems (ITS) Steering Committees. (A) Purpose. Federal law encourages the expenditure of federal transportation funds to achieve improvements in the efficiency of transportation operations. A portion of these funds are specifically designated for the planning and testing of Intelligent Transportation Systems technologies. As part of the development and implementation of these projects, a district engineer, in conjunction with local officials, may create a steering committee to provide support for ITS activities. Advice and recommendations expressed by a committee will foster the coordination of state and local benefit in the design, maintenance, and operation of ITS facilities. (B) Duties. A committee shall provide advice and recommendations with respect to: (i) ITS project priorities; (ii) the approval of projects; (iii) seeking project funding; (iv) coordinating public and private ventures; and (v) promoting ITS at local, state, and national levels. (C) Manner of reporting. A committee shall report its advice and recommendations to the local district engineer, or his or her designee. (7) Motor Transportation Advisory Committee. (A) Purpose. The Motor Transportation Advisory Committee provides a forum for communication among state agencies, the trucking industry, motor bus companies that do not operate wholly within the limits of any incorporated town or city and its suburbs, and the affected public in a cooperative effort to seek solutions to common problems, and to support the department's mission to work cooperatively to provide safe, effective, and efficient movement of people and goods. (B) Duties. The Motor Transportation Advisory Committee shall provide advice with respect to: (i) the issuance of permits for the movement of oversize and overweight vehicles and loads; (ii) the registration of trucks and motor buses; (iii) future truck and motor bus equipment and highway needs; (iv) coordination of regulatory and enforcement activities of state agencies affecting the trucking and motor bus industries. (v) truck and motor bus safety; (vi) opportunities for one-stop shopping for state services and requirements of trucks and motor bus companies; and (vii) other issues concerning the department and the trucking and motor bus industries. (C) Manner of reporting. The committee shall report its advice and recommendations to the assistant executive director for motorist services and the assistant executive director for multimodal transportation. (8) Bicycle Advisory Committee. (A) Purpose. The purpose of the Bicycle Advisory Committee is to advise the commission on bicycle issues. By involving representatives of the public, including bicyclists, the department helps ensure effective communication with the bicycle community, and that the bicyclist's perspective will be considered in the development of departmental policies affecting bicycle use including, the design, construction and maintenance of highways. (B) Duties. The committee shall review and make recommendations on items of mutual concern between the department and the bicycling community. (C) Manner of reporting. The committee shall report its advice and recommendations to the commission. (D) Creation. The effective date for establishment of the bicycle advisory committee will be the same date that the Bicycle Rules Advisory Committee is abolished. (E) Reimbursement. The department may reimburse a member of the Bicycle Advisory Committee for reasonable and necessary travel expenses. Current rules and laws governing reimbursement of expenses for state employees shall govern reimbursement of expenses for advisory committee members. (9) Partners in Texas Transportation Safety Committee. (A) Purpose. The Partners in Texas Transportation Safety Committee provides advice and makes recommendations to improve transportation safety by identifying and evaluating safety issues for consideration in transportation strategies, plans, and projects. (B) Duties. The committee shall: (i) develop and recommend safety goals and objectives for the state through consideration of current transportation trends; (ii) identify and recommend safety policies, procedures, and processes which affect safety-related decisions; and (iii) coordinate and communicate transportation issues with other agencies and individuals to ensure a functional and productive safety management system. (C) Subcommittees. (i) The committee may appoint subcommittees to work independently on select safety issues. (ii) A subcommittee shall report its finding or recommendation to the committee chair. (D) Manner of reporting. The committee shall report its advice and recommendations to the participating agencies and the Director of Traffic Operations. (E) Duration. The committee is abolished September 1, 1999, unless continued in existence by affirmative vote of the commission. (b) Operating procedures. (1) Membership. An advisory committee shall be composed of not more than 24 members to be appointed by the office or official to whom the committee is to report. When applicable to the purpose and duties of the committee, the membership shall provide a balanced representation between: (A) industries or occupations regulated or directly affected by the department; and (B) consumers of services provided either by the department or by industries or occupations regulated by the department. (2) Meetings. (A) An advisory committee shall meet once a calendar year and such other times as requested by the office to which it reports. (B) A majority of the membership of an advisory committee constitutes a quorum. A committee may take formal action only by majority vote of its membership. (3) Officers. Each committee shall elect a chair and vice-chair by majority vote of the members of the committee. (c) Duration. Except as otherwise specified in this subsection, a committee created under this section is abolished September 1, 1999, unless continued in existence by affirmative vote of the commission. This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority. Issued in Austin, Texas, on August 4, 1997. TRD-9710060 Bob Jackson Deputy General Counsel Texas Department of Transportation Effective date: August 25, 1997 Proposal publication date: June 10, 1997 For further information, please call: (512) 463-8630