Bill Text: TX HB3269 | 2019-2020 | 86th Legislature | Introduced


Bill Title: Relating to level of care designations for hospitals that provide neonatal and maternal care.

Spectrum: Partisan Bill (Republican 2-0)

Status: (Introduced) 2019-03-13 - Referred to Public Health [HB3269 Detail]

Download: Texas-2019-HB3269-Introduced.html
  86R7215 JG-D
 
  By: Price H.B. No. 3269
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to level of care designations for hospitals that provide
  neonatal and maternal care.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 241.183, Health and Safety Code, is
  amended by amending Subsection (a) and adding Subsection (f) to
  read as follows:
         (a)  The executive commissioner, in consultation with the
  commission [department], shall adopt rules:
               (1)  establishing the levels of care for neonatal and
  maternal care to be assigned to hospitals;
               (2)  prescribing criteria for designating levels of
  neonatal and maternal care, respectively, including specifying the
  minimum requirements to qualify for each level designation;
               (3)  establishing a process for the assignment of
  levels of care to a hospital for neonatal and maternal care,
  respectively;
               (4)  establishing a process for amending the level of
  care designation requirements, including a process for assisting
  facilities in implementing any changes made necessary by the
  amendments;
               (5)  dividing the state into neonatal and maternal care
  regions;
               (6)  facilitating transfer agreements through regional
  coordination;
               (7)  requiring payment, other than quality or
  outcome-based funding, to be based on services provided by the
  facility, regardless of the facility's level of care designation;
  [and]
               (8)  prohibiting the denial of a neonatal or maternal
  level of care designation to a hospital that meets the minimum
  requirements for that level of care designation;
               (9)  establishing a process through which a hospital
  may appeal to an independent third party regarding the level of care
  designation assigned to the hospital;
               (10)  permitting a health care provider who provides
  care at a hospital assigned a Level I or II level of care
  designation to provide each health care service for which the
  provider is licensed if the hospital demonstrates a need for the
  service; and
               (11)  specifying the situations in which a hospital can
  receive off-site medical consulting or services to meet the
  requirements for a level of care designation.
         (f)  In adopting rules under Subsection (a), the executive
  commissioner shall ensure that any requirement for a level of care
  designation related to care for patients of a particular
  gestational age or for a specified number of patients of a
  particular gestational age provides flexibility based on the
  geographic area in which the hospital is located and the hospital's
  capabilities for providing care.
         SECTION 2.  Subchapter H, Chapter 241, Health and Safety
  Code, is amended by adding Sections 241.1835 and 241.1865 to read as
  follows:
         Sec. 241.1835.  USE OF TELEHEALTH SERVICES AND TELEMEDICINE
  MEDICAL SERVICES AT CERTAIN HOSPITALS. (a) In this section,
  "telehealth service" and "telemedicine medical service" have the
  meanings assigned by Section 111.001, Occupations Code.
         (b)  In adopting rules under Section 241.183, the executive
  commissioner may not exclude or prohibit the use of telehealth
  services or telemedicine medical services by a physician providing
  on-call services at a hospital located in a rural area of this
  state, as defined by executive commissioner rule, that is assigned
  a Level I, II, or III level of care designation. This section
  applies only to on-call services provided:
               (1)  at a hospital with a local medical staff
  consisting of not more than four physicians; and
               (2)  for a hospital assigned a Level II or III level of
  care designation, by a physician licensed to practice medicine
  under Subtitle B, Title 3, Occupations Code, and board certified in
  obstetrics or gynecology.
         (c)  This section does not waive the requirements for a level
  of care designation.
         Sec. 241.1865.  WAIVER FROM LEVEL OF CARE DESIGNATION
  REQUIREMENTS. (a)  The executive commissioner by rule shall
  develop and implement a process through which a hospital may enter
  into an agreement with the commission to waive one or more
  requirements for a level of care designation.
         (b)  The executive commissioner by rule shall adopt
  requirements to enter into a waiver agreement under Subsection (a)
  and specify the type of designation requirements that may be
  waived.
         (c)  A waiver agreement entered into under Subsection (a):
               (1)  must expire at the end of each designation cycle
  but may be renewed by the commission under the same or different
  terms; and
               (2)  may require a hospital to meet the requirements
  for a level of care designation within the period specified under
  the agreement.
         (d)  A hospital that enters into a waiver agreement under
  Subsection (a) is required to satisfy all other requirements for a
  level of care designation that are not waived in the agreement.
         SECTION 3.  Section 241.187, Health and Safety Code, is
  amended by amending Subsection (l) and adding Subsection (m) to
  read as follows:
         (l)  The advisory council is subject to Chapter 325,
  Government Code (Texas Sunset Act). The advisory council shall be
  reviewed during the period in which the Department of State Health
  Services is reviewed [Unless continued in existence as provided by
  that chapter, the advisory council is abolished and this section
  expires September 1, 2025].
         (m)  The executive commissioner, in consultation with the
  commission and the advisory council, shall:
               (1)  conduct a strategic review of the practical
  implementation of rules adopted by the executive commissioner under
  this subchapter that at a minimum identifies:
                     (A)  barriers to a hospital obtaining the
  hospital's preferred level of care designation; and
                     (B)  whether the barriers identified under
  Paragraph (A) are appropriate;
               (2)  based on the review conducted under Subdivision
  (1), modify rules adopted under this subchapter, as appropriate, to
  improve the process and methodology of assigning level of care
  designations; and
               (3)  prepare and submit to the legislature each
  biennium a written report that summarizes:
                     (A)  the review conducted under Subdivision (1);
  and
                     (B)  actions taken by the executive commissioner
  based on the review.
         SECTION 4.  As soon as practicable after the effective date
  of this Act, the executive commissioner of the Health and Human
  Services Commission shall adopt rules as necessary to implement the
  changes in law made by this Act.
         SECTION 5.  This Act takes effect September 1, 2019.
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