Texas 2009 - 81st Regular

Texas House Bill HB3100 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	81R10792 YDB-D
2	2	By: Leibowitz H.B. No. 3100
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to billing for certain adverse events that occur during
8	8	the provision of health care services.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. The heading to Subtitle I, Title 2, Health and
11	11	Safety Code, is amended to read as follows:
12	12	SUBTITLE I. MEDICAL RECORDS AND BILLING
13	13	SECTION 2. Subtitle I, Title 2, Health and Safety Code, is
14	14	amended by adding Chapter 183 to read as follows:
15	15	CHAPTER 183. PROHIBITED BILLING PRACTICES
16	16	Sec. 183.001. DEFINITIONS. In this chapter:
17	17	(1) "Health care facility" means a facility licensed,
18	18	certified, or otherwise authorized by the laws of this state to
19	19	administer health care, for profit or otherwise, in the ordinary
20	20	course of business.
21	21	(2) "Health care provider" means a person or facility
22	22	licensed, certified, or otherwise authorized by the laws of this
23	23	state to administer health care, for profit or otherwise, in the
24	24	ordinary course of business or professional practice.
25	25	(3) "Serious disability" means:
26	26	(A) a physical or mental impairment that
27	27	substantially limits one or more major life activities of an
28	28	individual such as seeing, hearing, speaking, walking, or
29	29	breathing, or a loss of a bodily function, if the impairment or loss
30	30	lasts more than seven days or is still present at the time of
31	31	discharge from an inpatient health care facility; or
32	32	(B) loss of a body part.
33	33	Sec. 183.002. PREVENTABLE ADVERSE EVENT. For purposes of
34	34	this chapter, a preventable adverse event is any of the following
35	35	events that occur during the provision of a health care service to a
36	36	patient:
37	37	(1) the unintended retention of a foreign object in
38	38	the patient after surgery or another procedure;
39	39	(2) death or serious disability caused by an
40	40	intravascular air embolism that occurs while the patient is
41	41	receiving care in a health care facility, excluding a death
42	42	associated with a neurological procedure known to present a high
43	43	risk of intravascular air embolism;
44	44	(3) death or serious disability of a patient caused by
45	45	a hemolytic reaction resulting from the administration of ABO- or
46	46	HLA-incompatible blood or blood products;
47	47	(4) stage three or four pressure ulcers acquired after
48	48	admission to a health care facility, excluding progression from
49	49	stage two to stage three if stage two was recognized on admission;
50	50	(5) death or serious disability caused by an electric
51	51	shock while the patient is receiving care in a health care facility,
52	52	excluding an event involving a planned treatment such as electric
53	53	countershock;
54	54	(6) death or serious disability caused by a burn
55	55	incurred from any source while the patient is receiving care in a
56	56	health care facility;
57	57	(7) death or serious disability caused by a fall or
58	58	trauma resulting in a fracture, dislocation, intracranial injury,
59	59	or crushing injury while the patient is receiving care in a health
60	60	care facility;
61	61	(8) death or serious disability directly related to
62	62	the following manifestations of poor glycemic control, the onset of
63	63	which occurs while the patient is receiving care in a health care
64	64	facility:
65	65	(A) diabetic ketoacidosis;
66	66	(B) nonketotic hyperosmolar coma;
67	67	(C) hypoglycemic coma;
68	68	(D) secondary diabetes with ketoacidosis; and
69	69	(E) secondary diabetes with hyperosmolarity;
70	70	(9) death or serious disability caused by a urinary
71	71	tract infection resulting from the insertion of a catheter by an
72	72	individual health care provider;
73	73	(10) death or serious disability caused by an
74	74	infection resulting from the insertion of a vascular catheter by an
75	75	individual health care provider;
76	76	(11) death or serious disability caused by a surgical
77	77	site infection occurring as a result of the following procedures:
78	78	(A) a coronary artery bypass graft;
79	79	(B) bariatric surgery such as laparoscopic
80	80	gastric bypass surgery, gastroenterostomy, and laparoscopic
81	81	gastric restrictive surgery; and
82	82	(C) orthopedic procedures involving the spine,
83	83	neck, shoulder, or elbow; and
84	84	(12) death or serious disability caused by a pulmonary
85	85	embolism or deep vein thrombosis that occurs while the patient is
86	86	receiving care in a health care facility following an orthopedic
87	87	procedure, including total knee replacement or hip replacement.
88	88	Sec. 183.003. PROHIBITED BILLING FOR PREVENTABLE ADVERSE
89	89	EVENT. A health care provider may not present or cause to be
90	90	presented to any person, including the state Medicaid program, an
91	91	insurer, or another third party payor, a bill or demand for payment
92	92	for a health care service that included a preventable adverse event
93	93	or a health care service provided to a patient in this state as a
94	94	result of or to correct a preventable adverse event that is caused
95	95	by the provider or a person employed or supervised by or holding
96	96	practice privileges from the provider.
97	97	Sec. 183.004. RULES. The appropriate regulatory agency of
98	98	this state that issues a license or certificate to a licensed health
99	99	care provider may adopt rules necessary to implement and enforce
100	100	this chapter.
101	101	Sec. 183.005. DISCIPLINARY ACTION. A licensed health care
102	102	provider who violates this chapter or a rule adopted under this
103	103	chapter by the appropriate regulatory agency of this state is
104	104	subject to disciplinary action by the regulatory agency under
105	105	applicable law, including revocation, suspension, or nonrenewal of
106	106	the provider's license.
107	107	SECTION 3. Section 183.003, Health and Safety Code, as
108	108	added by this Act, applies only to a preventable adverse event
109	109	occurring on or after November 1, 2009.
110	110	SECTION 4. If before implementing any provision of this Act
111	111	a state agency determines that a waiver or authorization from a
112	112	federal agency is necessary for implementation of that provision,
113	113	the agency affected by the provision shall request the waiver or
114	114	authorization and may delay implementing that provision until the
115	115	waiver or authorization is granted.
116	116	SECTION 5. This Act takes effect September 1, 2009.