84R7918 SCL-D
 
  By: Garcia S.B. No. 1980
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the participation of an advanced practice nurse as a
  primary care provider for certain governmental and other health
  benefit plans.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 533.005, Government Code, is amended by
  adding Subsection (d) to read as follows:
         (d)  For purposes of Subsection (a)(13), an advanced
  practice nurse, including an advanced practice nurse certified as a
  psychiatric/mental health advanced practice nurse, may be included
  as a primary care provider in a managed care organization's
  provider network regardless of whether the physician delegating to
  or supervising the advanced practice nurse under Subchapter B,
  Chapter 157, Occupations Code, is in the provider network. If a
  managed care organization includes an advanced practice nurse as a
  primary care provider under this subsection, the physician
  delegating to or supervising the advanced practice nurse is part of
  the network for purposes of supervision. This subsection may not be
  construed as authorizing a managed care organization to supervise
  or control the practice of medicine as prohibited by Subtitle B,
  Title 3, Occupations Code.
         SECTION 2.  Section 62.1551, Health and Safety Code, is
  amended to read as follows:
         Sec. 62.1551.  INCLUSION OF CERTAIN HEALTH CARE PROVIDERS IN
  PROVIDER NETWORKS. (a)  Notwithstanding any other law, including
  Sections 843.312 and 1301.052, Insurance Code, the executive
  commissioner of the commission shall adopt rules to require a
  managed care organization or other entity to ensure that advanced
  practice registered nurses and physician assistants are available
  as primary care providers in the organization's or entity's
  provider network.  The rules must require advanced practice
  registered nurses and physician assistants to be treated in the
  same manner as primary care physicians with regard to:
               (1)  selection and assignment as primary care
  providers;
               (2)  inclusion as primary care providers in the
  provider network; and
               (3)  inclusion as primary care providers in any
  provider network directory maintained by the organization or
  entity.
         (b)  For purposes of Subsection (a), an advanced practice
  nurse, including an advanced practice nurse certified as a
  psychiatric/mental health advanced practice nurse, may be included
  as a primary care provider in a managed care organization's or
  entity's provider network regardless of whether the physician
  delegating to or supervising the advanced practice nurse under
  Subchapter B, Chapter 157, Occupations Code, is in the provider
  network. If a managed care organization or other entity includes an
  advanced practice nurse as a primary care provider under this
  subsection, the physician delegating to or supervising the advanced
  practice nurse is part of the provider network for purposes of
  supervision.
         (c)  This section may not be construed as authorizing a
  managed care organization or other entity to supervise or control
  the practice of medicine as prohibited by Subtitle B, Title 3,
  Occupations Code.
         SECTION 3.  Section 32.024(gg), Human Resources Code, is
  amended to read as follows:
         (gg)  Notwithstanding any other law, including Sections
  843.312 and 1301.052, Insurance Code, the department shall ensure
  that advanced practice registered nurses, including advanced
  practice registered nurses certified as psychiatric/mental health
  advanced practice nurses, and physician assistants may be selected
  by and assigned to recipients of medical assistance as the primary
  care providers of those recipients regardless of whether the
  physician delegating to or supervising the advanced practice
  registered nurse under Subchapter B, Chapter 157, Occupations Code,
  is included in any directory of providers of medical assistance
  maintained by the department. If an advanced practice registered
  nurse is included as a primary care provider under this subsection,
  the physician delegating to or supervising the advanced practice
  registered nurse is included in the directory for purposes of
  supervision. This subsection may not be construed as authorizing
  the department to supervise or control the practice of medicine as
  prohibited by Subtitle B, Title 3, Occupations Code.  The
  department must require that advanced practice registered nurses
  and physician assistants be treated in the same manner as primary
  care physicians with regard to:
               (1)  selection and assignment as primary care
  providers; and
               (2)  inclusion as primary care providers in any
  directory of providers of medical assistance maintained by the
  department.
         SECTION 4.  Subchapter I, Chapter 843, Insurance Code, is
  amended by adding Section 843.3125 to read as follows:
         Sec. 843.3125.  CONTRACTS WITH ADVANCED PRACTICE NURSES.
  (a) A health maintenance organization may contract directly with
  an advanced practice nurse to provide health care services on
  behalf of the health maintenance organization regardless of whether
  the physician delegating to or supervising the advanced practice
  nurse under Subchapter B, Chapter 157, Occupations Code, provides
  health care services for the health maintenance organization.
         (b)  If a health maintenance organization contracts directly
  with an advanced practice nurse under Subsection (a), the physician
  delegating to or supervising the advanced practice nurse is part of
  an applicable limited provider network for purposes of supervision.
         (c)  This section may not be construed as authorizing a
  health maintenance organization to supervise or control the
  practice of medicine as prohibited by Subtitle B, Title 3,
  Occupations Code.
         SECTION 5.  Subchapter B, Chapter 1301, Insurance Code, is
  amended by adding Section 1301.0525 to read as follows:
         Sec. 1301.0525.  DESIGNATION OF ADVANCED PRACTICE NURSES AS
  PREFERRED PROVIDERS. (a) An insurer offering a preferred provider
  benefit plan may designate an advanced practice nurse as a
  preferred provider regardless of whether the physician delegating
  to or supervising the advanced practice nurse under Subchapter B,
  Chapter 157, Occupations Code, is a preferred provider.
         (b)  If an insurer designates an advanced practice nurse as a
  preferred provider under Subsection (a), the physician delegating
  to or supervising the advanced practice nurse is a preferred
  provider for purposes of supervision.
         (c)  This section may not be construed as authorizing an
  insurer to supervise or control the practice of medicine as
  prohibited by Subtitle B, Title 3, Occupations Code.
         SECTION 6.  If before implementing any provision of this Act
  a state agency determines that a waiver or authorization from a
  federal agency is necessary for implementation of that provision,
  the agency affected by the provision shall request the waiver or
  authorization and may delay implementing that provision until the
  waiver or authorization is granted.
         SECTION 7.  This Act takes effect September 1, 2015.