By: Duncan S.B. No. 1500
(In the Senate - Filed March 6, 2009; March 17, 2009, read
first time and referred to Committee on State Affairs;
April 16, 2009, reported adversely, with favorable Committee
Substitute by the following vote: Yeas 5, Nays 1; April 16, 2009,
sent to printer.)
COMMITTEE SUBSTITUTE FOR S.B. No. 1500 By: Duncan
A BILL TO BE ENTITLED
AN ACT
relating to the employment of physicians by certain hospitals.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 311, Health and Safety Code, is amended
by adding Subchapter E to read as follows:
SUBCHAPTER E. EMPLOYMENT OF PHYSICIANS BY CERTAIN HOSPITALS
Sec. 311.061. APPLICABILITY OF SUBCHAPTER. This subchapter
applies only to a hospital that:
(1) is designated as a critical access hospital under
the authority of and in compliance with 42 U.S.C. Section 1395i-4;
(2) is a sole community hospital, as that term is
defined by 42 U.S.C. Section 1395ww(d)(5)(D)(iii); or
(3) is located in a county with a population of 50,000
or less.
Sec. 311.062. EMPLOYMENT OF PHYSICIAN PERMITTED. (a) A
hospital may employ a physician and retain all or part of the
professional income generated by the physician for medical services
provided at the hospital.
(b) A hospital located in a county with a population of
50,000 or less may continue to employ any physicians employed by the
hospital on or before the date of release of a federal decennial
census that shows the county's population exceeds 50,000. The
hospital may not employ a new physician after that date.
Sec. 311.063. HOSPITAL POLICIES. (a) A hospital shall
adopt and maintain policies to ensure that a physician employed
under this subchapter whose professional income is retained under
Section 311.062 exercises independent medical judgment when
providing care to patients at the hospital.
(b) The policies adopted under this section must include
policies relating to:
(1) credentialing;
(2) quality assurance;
(3) utilization review;
(4) peer review;
(5) medical decision-making; and
(6) due process.
Sec. 311.064. CREDENTIALING AND PRIVILEGES. (a) A
physician employed by a hospital under this subchapter is subject
to the same standards and procedures regarding credentialing, peer
review, quality of care, and privileges as a physician not employed
by the hospital.
(b) A hospital shall give equal consideration regarding the
issuance of credentials and privileges to physicians employed by
the hospital and physicians not employed by the hospital.
Sec. 311.065. OTHER HOSPITAL-PHYSICIAN RELATIONSHIPS.
This subchapter may not be construed as altering, voiding, or
prohibiting any relationship between a hospital and a physician,
including a contract or arrangement with an approved nonprofit
health corporation that is certified under Section 162.001(b),
Occupations Code, and that holds a certificate of authority issued
under Chapter 844, Insurance Code.
SECTION 2. Section 162.001, Occupations Code, is amended by
adding Subsection (d) to read as follows:
(d) The board shall certify a health organization to employ
physicians licensed by the board if the organization:
(1) is a critical access hospital under the authority
of and in compliance with 42 U.S.C. Section 1395i-4;
(2) is a sole community hospital, as that term is
defined by 42 U.S.C. Section 1395ww(d)(5)(D)(iii); or
(3) is located in a county with a population of 50,000
or less.
SECTION 3. Subchapter A, Chapter 162, Occupations Code, is
amended by adding Section 162.004 to read as follows:
Sec. 162.004. EMPLOYER AND EMPLOYEE REQUIREMENTS. The
following requirements apply to an organization certified under
Section 162.001(d) that employs physicians:
(1) a physician shall retain independent medical
judgment in providing care to patients at the organization and may
not be penalized for reasonably advocating for patient care;
(2) the organization shall provide a certain portion
of medical services free of charge, or at a reduced fee commensurate
with a patient's ability to pay;
(3) a physician employed by the organization shall
participate in the provision of services under Subdivision (2);
(4) an organization may not include a non-compete
clause on termination in a physician employment contract; and
(5) a physician who has privileges at the organization
and is employed by the hospital and a physician who is not employed
by the hospital must be given equal consideration and treatment in
the creation and execution of all medical staff bylaw provisions
regardless of the physician's employer.
SECTION 4. This Act takes effect September 1, 2009.
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