Bill Text: TX HB1873 | 2023-2024 | 88th Legislature | Introduced
Bill Title: Relating to patients' rights, consumer protection, and directives for the provision of health care services; providing an administrative penalty.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2023-03-07 - Referred to Public Health [HB1873 Detail]
Download: Texas-2023-HB1873-Introduced.html
88R1396 SCL-F | ||
By: Campos | H.B. No. 1873 |
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relating to patients' rights, consumer protection, and directives | ||
for the provision of health care services; providing an | ||
administrative penalty. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subchapter A, Chapter 166, Health and Safety | ||
Code, is amended by adding Section 166.012 to read as follows: | ||
Sec. 166.012. DIRECTIVE FOR PHYSICIAN DIAGNOSIS AND | ||
TREATMENT. (a) A competent adult may execute a written directive | ||
that: | ||
(1) requires any diagnosis or treatment provided to | ||
the adult to be provided only by a physician; and | ||
(2) provides that if the adult is incompetent or | ||
otherwise mentally or physically incapable of communication, only a | ||
physician may diagnose and treat the adult. | ||
(b) Except as provided by Subsection (c), the declarant must | ||
sign the directive in the presence of two witnesses who qualify | ||
under Section 166.003, at least one of whom must be a witness who | ||
qualifies under Section 166.003(2). The witnesses must sign the | ||
directive. | ||
(c) The declarant, in lieu of signing in the presence of | ||
witnesses, may sign the directive and have the signature | ||
acknowledged before a notary public. | ||
(d) A declarant shall notify the declarant's attending | ||
physician of the existence of the written directive. If the | ||
declarant is incompetent or otherwise mentally or physically | ||
incapable of communication, another person may notify the attending | ||
physician of the existence of the directive. The attending | ||
physician shall make the directive a part of the declarant's | ||
medical record. | ||
(e) A directive described by Subsection (a) prevails over a | ||
conflicting directive unless the conflicting directive is later | ||
executed and states that the directive executed under this section | ||
is revoked. | ||
SECTION 2. Title 2, Health and Safety Code, is amended by | ||
adding Subtitle J to read as follows: | ||
SUBTITLE J. PROVISION OF HEALTH CARE SERVICES | ||
CHAPTER 185. TEXAS PATIENTS' BILL OF RIGHTS | ||
SUBCHAPTER A. GENERAL PROVISIONS | ||
Sec. 185.001. DEFINITIONS. In this chapter: | ||
(1) "Health care facility" means a facility licensed, | ||
certified, registered, or otherwise authorized to administer | ||
health care services, for profit or otherwise, to individuals in | ||
this state in the ordinary course of business or professional | ||
practice. | ||
(2) "Health care practitioner" means an individual | ||
licensed, certified, registered, or otherwise authorized to | ||
administer health care services, for profit or otherwise, to | ||
individuals in this state in the ordinary course of business or | ||
practice. | ||
(3) "Health care services" means services provided by | ||
a health care practitioner to prevent, alleviate, cure, or heal | ||
human illness or injury. | ||
Sec. 185.002. PURPOSE. The purpose of this chapter is to | ||
provide the necessary information for patients to make informed | ||
decisions on health care services. | ||
Sec. 185.003. APPLICABILITY. (a) Except as provided by | ||
Subsection (b), this chapter applies to each health care facility | ||
in this state, including hospitals, freestanding emergency medical | ||
care facilities, hospital-owned outpatient clinics, urgent care | ||
centers, and ambulatory surgical centers, and each health care | ||
practitioner in this state. | ||
(b) This chapter does not apply to a dentist, physical | ||
therapist, or chiropractor. | ||
Sec. 185.004. RULES. A state regulatory agency that issues | ||
a license, certification, registration, or other authorization to a | ||
health care facility or health care practitioner, including The | ||
Texas Medical Board, Texas Physician Assistant Board, Texas Board | ||
of Nursing, and executive commissioner, may adopt rules necessary | ||
to implement this chapter. | ||
SUBCHAPTER B. PATIENT RIGHTS | ||
Sec. 185.051. RIGHTS RELATED TO HEALTH CARE PRACTITIONERS. | ||
A patient in this state has the right to: | ||
(1) be informed of the type of license a health care | ||
practitioner holds by viewing a photo identification worn by the | ||
practitioner in accordance with Section 185.102; | ||
(2) be informed about whether a supervising physician | ||
is present at the health care facility at the time the patient | ||
receives health care services at the facility; | ||
(3) decline health care services provided by a | ||
nonphysician health care practitioner and instead request that a | ||
physician provide the health care services within a reasonable | ||
time; | ||
(4) be informed in advance of the patient's health care | ||
appointment of the health care practitioner scheduled to provide | ||
health care services to the patient; | ||
(5) avoid any penalty for the patient's refusal to | ||
accept provision of health care services by a nonphysician health | ||
care practitioner; | ||
(6) be provided an initial consultation only with a | ||
specialist who is a physician; | ||
(7) be informed of the identity of the physician | ||
supervising each nonphysician health care practitioner involved in | ||
providing health care services to the patient; and | ||
(8) be provided accurate health care information that | ||
is not misleading or deceptive in a manner prohibited under Section | ||
102.0015, Occupations Code. | ||
Sec. 185.052. RIGHTS RELATED TO INFORMED CONSENT. (a) A | ||
patient in this state has the right to: | ||
(1) receive a clearly readable and intelligible copy | ||
of all consent to treat forms before the patient is asked to sign | ||
those forms; | ||
(2) receive and execute a one-page document | ||
authorizing only a physician to diagnose and treat the patient; | ||
(3) receive simplified paperwork that does not require | ||
the patient to enter duplicate information on multiple forms; | ||
(4) execute an advance directive under Section 166.012 | ||
requiring that only a physician diagnose and treat the patient, | ||
including when the patient is unable to communicate; and | ||
(5) receive documentation with a clear explanation of | ||
each proposed health care service, including medications, and any | ||
practicable alternatives to each service. | ||
(b) A reference on an electronic device to a consent to | ||
treat form or another document that the patient has not received | ||
does not satisfy the requirements of Subsection (a)(1). | ||
Sec. 185.053. RIGHTS RELATED TO TREATMENT. A patient in | ||
this state has the right to: | ||
(1) if practicable, have an advocate, including a | ||
family member or other individual, present with the patient during | ||
the provision of health care services; | ||
(2) receive an easily understandable summary of the | ||
health care services provided to the patient; | ||
(3) for hospitalized patients, have an accurate active | ||
medication list maintained at all times while the patient remains | ||
hospitalized; and | ||
(4) as applicable, receive documentation stating that | ||
the patient's treatment is deviating from the standard of care | ||
because of cost, health benefit plan coverage, or hospital supply | ||
shortage. | ||
Sec. 185.054. RIGHTS RELATED TO BILLING. A patient in this | ||
state has the right to receive: | ||
(1) if practicable, a written estimate of the cost of | ||
health care services, including the cost of directly paying the | ||
health care practitioner or health care facility that provides the | ||
services rather than paying through a health benefit plan; | ||
(2) written notice on whether the patient's health | ||
benefit plan covers a health care service; | ||
(3) a written disclosure on whether any health care | ||
practitioner who may provide health care services to the patient is | ||
an independent contractor who bills separately; and | ||
(4) a reduced price for health care services provided | ||
by a nonphysician health care practitioner. | ||
SUBCHAPTER C. REQUIREMENTS FOR HEALTH CARE FACILITIES AND | ||
PRACTITIONERS | ||
Sec. 185.101. PROHIBITED ABRIDGEMENT OF RIGHTS OR VIOLATION | ||
OF RULES. A health care facility or health care practitioner may | ||
not abridge a right described by Subchapter B or violate a rule | ||
adopted under this chapter. | ||
Sec. 185.102. PHOTO IDENTIFICATION REQUIREMENTS FOR HEALTH | ||
CARE PRACTITIONERS. (a) While providing health care services to a | ||
patient, a health care practitioner shall wear a clearly visible | ||
photo identification that identifies the practitioner's | ||
occupational license, certification, registration, or other | ||
authorization issued under Title 3, Occupations Code, or the | ||
occupational license, certification, registration, or other | ||
authorization for which the practitioner is training under that | ||
title. | ||
(b) The photo identification must clearly state the health | ||
care practitioner's occupation and may not abbreviate the | ||
occupation. | ||
(c) The photo identification for a health care practitioner | ||
who is training to hold a license, certification, registration, or | ||
other authorization under Title 3, Occupations Code, must identify | ||
the practitioner as a student, resident, or fellow. | ||
Sec. 185.103. INFORMATION REGARDING NONPHYSICIAN HEALTH | ||
CARE PRACTITIONERS. A health care facility employing nonphysician | ||
health care practitioners at a facility location shall clearly post | ||
in each patient waiting area at the location and on all | ||
advertisements for health care services provided at the location | ||
that: | ||
(1) health care services are provided by nonphysician | ||
health care practitioners; and | ||
(2) the patient has the right to be informed of the | ||
identity of the supervising physician of any nonphysician health | ||
care provider who provides health care services to the patient. | ||
Sec. 185.104. PROVISION OF TRAINING INFORMATION. A health | ||
care facility in this state shall post the differences in training | ||
requirements for the health care practitioners employed by the | ||
facility on the facility's Internet website and in each of the | ||
facility's patient waiting areas. | ||
SUBCHAPTER D. ENFORCEMENT | ||
Sec. 185.151. REPORT. A patient may report a violation of a | ||
right described by Subchapter B to: | ||
(1) the state regulatory agency that issues a license, | ||
certification, registration, or other authorization to a health | ||
care practitioner, including: | ||
(A) the Texas Medical Board for physicians; | ||
(B) the Texas Physician Assistant Board for | ||
physician assistants; and | ||
(C) the Texas Board of Nursing for nurses; and | ||
(2) the state regulatory agency that issues a license, | ||
certification, registration, or other authorization to a health | ||
care facility, including the commission. | ||
Sec. 185.152. ADMINISTRATIVE PENALTY. (a) A state | ||
regulatory agency for a health care facility or health care | ||
practitioner, including the Texas Medical Board, the Texas | ||
Physician Assistant Board, the Texas Board of Nursing, and the | ||
commission, may impose an administrative penalty against a person | ||
regulated by the agency who violates this chapter or a rule adopted | ||
under this chapter. | ||
(b) The assessed penalty may not be less than $100 or more | ||
than $10,000 for each violation. Each day of a violation that | ||
occurs before the day on which the person receives written notice of | ||
the violation does not constitute a separate violation and shall be | ||
considered one violation. Each day of a continuing violation that | ||
occurs after the day on which the person receives written notice of | ||
the violation constitutes a separate violation. | ||
SECTION 3. Subchapter A, Chapter 102, Occupations Code, is | ||
amended by adding Section 102.0015 to read as follows: | ||
Sec. 102.0015. REQUIREMENTS AND PROHIBITED PRACTICES | ||
RELATED TO QUALIFICATIONS IN ADVERTISEMENTS. (a) A person may not | ||
make a deceptive or misleading statement or engage in a deceptive or | ||
misleading act in advertising health care services that | ||
misrepresents: | ||
(1) whether the person holds a license, certification, | ||
registration, or other authorization issued by this state to | ||
provide the services; or | ||
(2) the person's education, training, or clinical | ||
expertise. | ||
(b) A person who is advertising health care services | ||
provided by the person shall disclose in the advertisement the | ||
applicable license, certification, registration, or other | ||
authorization under which the person is authorized to provide the | ||
services. | ||
SECTION 4. Section 102.008, Occupations Code, is amended to | ||
read as follows: | ||
Sec. 102.008. DISCIPLINARY ACTION. A violation of Section | ||
102.001, 102.0015, or 102.006 is grounds for disciplinary action by | ||
the regulatory agency that issued a license, certification, or | ||
registration to the person who committed the violation. | ||
SECTION 5. Each state regulatory agency that issues a | ||
license, certification, registration, or other authorization to a | ||
health care practitioner or health care facility, including the | ||
Texas Medical Board, Texas Physician Assistant Board, Texas Board | ||
of Nursing, and executive commissioner of the Health and Human | ||
Services Commission, shall adopt rules necessary to implement | ||
Chapter 185, Health and Safety Code, as added by this Act, not later | ||
than January 1, 2024. | ||
SECTION 6. Chapter 185, Health and Safety Code, as added by | ||
this Act, applies to the provision of health care services on or | ||
after January 1, 2024. | ||
SECTION 7. This Act takes effect September 1, 2023. |