Texas 2009 - 81st Regular

Texas House Bill HB344 Compare Versions

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

Old	New	Differences
1	1	81R440 CLG-D
2	2	By: Leibowitz H.B. No. 344
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to reimbursement under the state Medicaid program for
8	8	health care services associated with certain adverse events.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subchapter B, Chapter 32, Human Resources Code,
11	11	is amended by adding Section 32.0312 to read as follows:
12	12	Sec. 32.0312. REIMBURSEMENT PROHIBITED FOR SERVICES
13	13	ASSOCIATED WITH PREVENTABLE ADVERSE EVENTS. (a) In this section:
14	14	(1) "Health care facility" means a hospital or
15	15	ambulatory surgical center.
16	16	(2) "Health care provider" means a physician or health
17	17	care facility.
18	18	(3) "Infant" means a child younger than one year of
19	19	age.
20	20	(4) "Serious disability" means:
21	21	(A) a physical or mental impairment that
22	22	substantially limits one or more major life activities of an
23	23	individual such as seeing, hearing, speaking, walking, or
24	24	breathing, or a loss of a bodily function, if the impairment or loss
25	25	lasts more than seven days or is still present at the time of
26	26	discharge from an inpatient health care facility; or
27	27	(B) loss of a body part.
28	28	(5) "Serious injury" means a bodily injury that
29	29	results in:
30	30	(A) death;
31	31	(B) permanent and serious impairment of an
32	32	important bodily function; or
33	33	(C) permanent and significant disfigurement.
34	34	(b) The department may not provide reimbursement under the
35	35	medical assistance program to a health care provider for a health
36	36	care service provided in association with a preventable adverse
37	37	event involving a recipient of medical assistance while in the
38	38	provider's care, including a health care service provided as a
39	39	result of or to correct the consequences of a preventable adverse
40	40	event.
41	41	(c) For purposes of this section, a preventable adverse
42	42	event is any of the following events involving a recipient of
43	43	medical assistance:
44	44	(1) surgery performed on the wrong body part that is
45	45	not consistent with the documented informed consent for that
46	46	recipient, excluding a situation requiring prompt action that
47	47	occurs in the course of surgery or an urgent situation that
48	48	precludes obtaining informed consent;
49	49	(2) surgery performed on the wrong person;
50	50	(3) the wrong surgical procedure performed on the
51	51	recipient that is not consistent with the documented informed
52	52	consent for that recipient, excluding a situation requiring prompt
53	53	action that occurs in the course of surgery or an urgent situation
54	54	that precludes obtaining informed consent;
55	55	(4) the unintended retention of a foreign object in
56	56	the recipient after surgery or another procedure;
57	57	(5) death during or immediately after surgery if the
58	58	recipient would be classified as a normal, healthy patient under
59	59	guidelines published by a national association of
60	60	anesthesiologists;
61	61	(6) death or serious disability caused by the use of a
62	62	contaminated drug, device, or biologic provided by a health care
63	63	provider if the contamination is the result of a generally
64	64	detectable contaminant in drugs, devices, or biologics regardless
65	65	of the source of the contamination or product;
66	66	(7) death or serious disability caused by the use or
67	67	function of a device during the recipient's care in which the device
68	68	is used for a function other than as intended;
69	69	(8) death or serious disability caused by an
70	70	intravascular air embolism that occurs while the recipient is
71	71	receiving care in a health care facility, excluding a death
72	72	associated with a neurological procedure known to present a high
73	73	risk of intravascular air emoblism;
74	74	(9) an infant being discharged to the wrong person;
75	75	(10) death or serious disability associated with the
76	76	recipient's disappearance for more than four hours, excluding the
77	77	death or serious disability of an adult recipient who has
78	78	decision-making capacity;
79	79	(11) suicide or attempted suicide resulting in serious
80	80	disability while the recipient is receiving care in a health care
81	81	facility if the suicide or attempted suicide is due to the
82	82	recipient's actions after admission to the facility, excluding a
83	83	death resulting from a self-inflicted injury that was the reason
84	84	for the recipient's admission to the facility;
85	85	(12) death or serious disability caused by a
86	86	medication error, including an error involving the wrong drug,
87	87	wrong dose, wrong patient, wrong time, wrong rate, wrong
88	88	preparation, or wrong route of administration;
89	89	(13) death or serious disability caused by a hemolytic
90	90	reaction resulting from the administration of ABO- or
91	91	HLA-incompatible blood or blood products;
92	92	(14) subject to Subsection (d), death or serious
93	93	disability caused by labor or delivery in a low-risk pregnancy
94	94	while the recipient is receiving care in a health care facility,
95	95	including death or serious disability occurring not later than 42
96	96	days after the delivery date;
97	97	(15) death or serious disability directly related to
98	98	hypoglycemia, the onset of which occurs while the recipient is
99	99	receiving care in a health care facility;
100	100	(16) death or serious disability, including
101	101	kernicterus, caused by failure to identify and treat
102	102	hyperbilirubinemia in a neonate before discharge from a health care
103	103	facility;
104	104	(17) stage three or four pressure ulcers acquired
105	105	after admission to a health care facility, excluding progression
106	106	from stage two to stage three if stage two was recognized on
107	107	admission;
108	108	(18) death or serious disability resulting from spinal
109	109	manipulative therapy;
110	110	(19) death or serious disability caused by an electric
111	111	shock while the recipient is receiving care in a health care
112	112	facility, excluding an event involving a planned treatment such as
113	113	electric countershock;
114	114	(20) an incident in which a line designated for oxygen
115	115	or other gas to be delivered to the recipient contains the wrong gas
116	116	or is contaminated by a toxic substance;
117	117	(21) death or serious disability caused by a burn
118	118	incurred from any source while the recipient is receiving care in a
119	119	health care facility;
120	120	(22) death or serious disability caused by a fall
121	121	while the recipient is receiving care in a health care facility;
122	122	(23) death or serious disability caused by the use of a
123	123	restraint or bed rail while the recipient is receiving care in a
124	124	health care facility;
125	125	(24) an instance of care for the recipient ordered or
126	126	provided by an individual impersonating a physician, nurse,
127	127	pharmacist, or other licensed health care professional;
128	128	(25) abduction of the recipient from a health care
129	129	facility;
130	130	(26) sexual assault of the recipient within or on the
131	131	grounds of a health care facility;
132	132	(27) death or significant injury resulting from a
133	133	physical assault of the recipient that occurs within or on the
134	134	grounds of a health care facility; and
135	135	(28) artificial insemination with the wrong donor
136	136	sperm or donor egg.
137	137	(d) For purposes of Subsection (c)(14), the death of a
138	138	recipient of medical assistance resulting from pulmonary or
139	139	amniotic fluid embolism, acute fatty liver of pregnancy, or
140	140	cardiomyopathy during the course of labor or delivery is not
141	141	considered a preventable adverse event.
142	142	(e) The department's refusal to reimburse a health care
143	143	provider under this section does not in itself create civil
144	144	liability and is not subject to discovery or admissible in any civil
145	145	action against the provider.
146	146	SECTION 2. Not later than November 1, 2009, the executive
147	147	commissioner of the Health and Human Services Commission shall
148	148	adopt rules necessary to implement Section 32.0312, Human Resources
149	149	Code, as added by this Act.
150	150	SECTION 3. Section 32.0312, Human Resources Code, as added
151	151	by this Act, applies only to a preventable adverse event occurring
152	152	on or after the effective date of the rules adopted by the executive
153	153	commissioner of the Health and Human Services Commission under
154	154	Section 2 of this Act.
155	155	SECTION 4. If before implementing any provision of this Act
156	156	a state agency determines that a waiver or authorization from a
157	157	federal agency is necessary for implementation of that provision,
158	158	the agency affected by the provision shall request the waiver or
159	159	authorization and may delay implementing that provision until the
160	160	waiver or authorization is granted.
161	161	SECTION 5. This Act takes effect September 1, 2009.