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 - Dead) 2019-03-13 - Referred to Public Health [HB3269 Detail]
Download: Texas-2019-HB3269-Introduced.html
86R7215 JG-D | ||
By: Price | H.B. No. 3269 |
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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 [ |
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(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; | ||
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(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 [ |
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(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. |