Bill Text: TX HB1532 | 2019-2020 | 86th Legislature | Engrossed
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Relating to the regulation of certain health organizations certified by the Texas Medical Board; providing an administrative penalty; authorizing a fee.
Spectrum: Partisan Bill (Republican 2-0)
Status: (Passed) 2019-06-10 - See remarks for effective date [HB1532 Detail]
Download: Texas-2019-HB1532-Engrossed.html
Bill Title: Relating to the regulation of certain health organizations certified by the Texas Medical Board; providing an administrative penalty; authorizing a fee.
Spectrum: Partisan Bill (Republican 2-0)
Status: (Passed) 2019-06-10 - See remarks for effective date [HB1532 Detail]
Download: Texas-2019-HB1532-Engrossed.html
86R15556 TSR-D | ||
By: Meyer | H.B. No. 1532 |
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relating to the regulation of certain health organizations | ||
certified by the Texas Medical Board; providing an administrative | ||
penalty; authorizing a fee. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 162.003, Occupations Code, is amended to | ||
read as follows: | ||
Sec. 162.003. REFUSAL TO CERTIFY; REVOCATION; PENALTY. On | ||
a determination that a health organization commits a violation of | ||
this subtitle or is established, organized, or operated in | ||
violation of or with the intent to violate this subtitle, the board | ||
may: | ||
(1) refuse to certify the health organization on | ||
application for certification by the organization under Section | ||
162.001; | ||
(2) revoke a certification made under Section 162.001 | ||
to that organization; or | ||
(3) impose an administrative penalty against the | ||
health organization under Subchapter A, Chapter 165. | ||
SECTION 2. Subchapter A, Chapter 162, Occupations Code, is | ||
amended by adding Sections 162.004, 162.005, and 162.006 to read as | ||
follows: | ||
Sec. 162.004. PROCEDURES FOR AND DISPOSITION OF COMPLAINTS | ||
AGAINST CERTAIN HEALTH ORGANIZATIONS. (a) The board shall accept | ||
and process complaints against a health organization certified | ||
under Section 162.001(b) for alleged violations of this subchapter | ||
or any other provision of this subtitle applicable to a health | ||
organization in the same manner as provided under Subchapter B, | ||
Chapter 154, and the rules adopted under that subchapter, including | ||
the requirements to: | ||
(1) maintain a system to promptly and efficiently act | ||
on complaints filed with the board; | ||
(2) with respect to a health organization that is the | ||
subject of a complaint, notify the health organization that a | ||
complaint has been filed, disclose the nature of the complaint, and | ||
provide the health organization with an opportunity to respond to | ||
the complaint; | ||
(3) ensure that a complaint is not dismissed without | ||
appropriate consideration; and | ||
(4) establish methods by which physicians employed by | ||
a health organization are notified of the name, mailing address, | ||
and telephone number of the board for the purpose of directing | ||
complaints under this section to the board. | ||
(b) Each complaint, adverse report, investigation file, | ||
other investigation report, and other investigative information in | ||
the possession of or received or gathered by the board or the | ||
board's employees or agents relating to a health organization | ||
certified under Section 162.001(b) is privileged and confidential | ||
and is not subject to discovery, subpoena, or other means of legal | ||
compulsion for release to anyone other than the board or the board's | ||
employees or agents involved in the investigation or discipline of | ||
a health organization certified under Section 162.001(b). | ||
(c) The board may dispose of a complaint or resolve the | ||
investigation of a complaint under this section in a manner | ||
provided under Subchapter A, Chapter 164, to the extent the board | ||
determines the provisions of that subchapter can be made applicable | ||
to a health organization certified under Section 162.001. | ||
(d) This section does not require an individual to file or | ||
prohibit an individual from filing a complaint against a health | ||
organization certified under Section 162.001(b) directly with the | ||
health organization, alone or in connection with a complaint filed | ||
with the board under this section, relating to: | ||
(1) the care or services provided by, or the policies | ||
of, the health organization; or | ||
(2) an alleged violation by the health organization of | ||
this subchapter or any other provision of this subtitle applicable | ||
to the health organization. | ||
Sec. 162.005. ANTI-RETALIATION POLICY. (a) A health | ||
organization certified under Section 162.001(b) shall develop, | ||
implement, and comply with an anti-retaliation policy for | ||
physicians under which the health organization may not terminate, | ||
demote, retaliate against, discipline, discriminate against, or | ||
otherwise penalize a physician for: | ||
(1) filing in good faith a complaint under Section | ||
162.004; | ||
(2) cooperating in good faith with an investigation or | ||
proceeding of the board relating to a complaint filed under Section | ||
162.004; or | ||
(3) communicating to a patient in good faith what the | ||
physician reasonably believes to be the physician's best, | ||
independent medical judgment. | ||
(b) On a determination that a health organization certified | ||
under Section 162.001(b) has failed to develop, implement, or | ||
comply with a policy described by Subsection (a), the board may take | ||
any action allowed under this subtitle or board rule applicable to a | ||
health organization. | ||
Sec. 162.006. BIENNIAL REPORT REQUIRED FOR CERTAIN HEALTH | ||
ORGANIZATIONS. (a) Each health organization certified under | ||
Section 162.001(b) shall file with the board a biennial report in | ||
September of each odd-numbered year if the organization was | ||
certified in an odd-numbered year or in September of each | ||
even-numbered year if the organization was certified in an | ||
even-numbered year. The biennial report must include: | ||
(1) a statement signed and verified by the president | ||
or chief executive officer of the health organization that: | ||
(A) provides the name and mailing address of: | ||
(i) the health organization; | ||
(ii) each member of the health | ||
organization, except that if the health organization has no | ||
members, a statement indicating that fact; | ||
(iii) each member of the board of directors | ||
of the health organization; and | ||
(iv) each officer of the health | ||
organization; and | ||
(B) discloses any change in the composition of | ||
the board of directors since the date of the most recent biennial | ||
report; | ||
(2) a statement signed and verified by the president | ||
or chief executive officer of the health organization that: | ||
(A) indicates whether the health organization's | ||
certificate of formation or bylaws were amended since the date of | ||
the most recent biennial report; | ||
(B) if applicable, provides a concise | ||
explanation of the amendments and states whether the amendments | ||
were recommended or approved by the board of directors; and | ||
(C) has attached to the statement a copy of the | ||
organization's current certificate of formation and bylaws if a | ||
copy is not already on file with the board; | ||
(3) a statement from each current director of the | ||
health organization, signed and verified by the director: | ||
(A) stating that the director is licensed by the | ||
board to practice medicine, is actively engaged in the practice of | ||
medicine, and has no restrictions on the director's license; | ||
(B) stating that the director will, as a | ||
director: | ||
(i) exercise independent judgment in all | ||
matters, specifically including matters relating to credentialing, | ||
quality assurance, utilization review, peer review, and the | ||
practice of medicine; | ||
(ii) exercise best efforts to cause the | ||
health organization to comply with all relevant provisions of this | ||
subtitle and board rules; and | ||
(iii) immediately report to the board any | ||
action or event the director reasonably and in good faith believes | ||
constitutes a violation or attempted violation of this subtitle or | ||
board rules; | ||
(C) identifying and concisely explaining the | ||
nature of each financial relationship the director has, if any, | ||
with a member, another director, or a supplier of the health | ||
organization or an affiliate of those persons; and | ||
(D) stating that the director has disclosed all | ||
financial relationships described by Paragraph (C); and | ||
(4) a statement signed and verified by the president | ||
or chief executive officer of the health organization indicating | ||
that the health organization is in compliance with the requirements | ||
for continued certification provided by this subtitle and board | ||
rules. | ||
(b) A health organization required to submit a biennial | ||
report under Subsection (a) shall submit with the report a fee in | ||
the amount prescribed by board rule. | ||
(c) Not later than January 1 of each year, the board shall | ||
publish on the board's Internet website the information provided to | ||
the board in each statement under Subsection (a)(1). | ||
(d) Information provided to the board in each statement | ||
under Subsections (a)(2), (3), and (4) is public information | ||
subject to disclosure under Chapter 552, Government Code. | ||
(e) The board may adopt rules necessary to implement this | ||
section. | ||
SECTION 3. Section 162.003, Occupations Code, as amended by | ||
this Act, and Section 162.004, Occupations Code, as added by this | ||
Act, apply only to a violation by a health organization that occurs | ||
on or after the effective date of this Act. A violation that occurs | ||
before the effective date of this Act is governed by the law in | ||
effect on the date the violation occurred, and the former law is | ||
continued in effect for that purpose. | ||
SECTION 4. Not later than December 31, 2019, a health | ||
organization certified under Section 162.001(b), Occupations Code, | ||
shall develop the anti-retaliation policy required by Section | ||
162.005, Occupations Code, as added by this Act. | ||
SECTION 5. (a) Except as provided by Subsection (b) of this | ||
section, this Act takes effect September 1, 2019. | ||
(b) Section 162.005(b), Occupations Code, as added by this | ||
Act, takes effect January 1, 2020. |