By: Williams S.B. No. 911
(In the Senate - Filed February 17, 2009; March 9, 2009,
read first time and referred to Committee on Health and Human
Services; April 14, 2009, reported adversely, with favorable
Committee Substitute by the following vote: Yeas 9, Nays 0;
April 14, 2009, sent to printer.)
COMMITTEE SUBSTITUTE FOR S.B. No. 911 By: Deuell
A BILL TO BE ENTITLED
AN ACT
relating to the certification and regulation of pain management
clinics.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle B, Title 3, Occupations Code, is
amended by adding Chapter 167 to read as follows:
CHAPTER 167. REGULATION OF PAIN MANAGEMENT CLINICS
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 167.001. DEFINITION. In this chapter, "pain
management clinic" means a publicly or privately owned facility for
which a majority of patients are issued on a monthly basis a
prescription for opioids, benzodiazepines, barbiturates, or
carisoprodol, but not including suboxone.
Sec. 167.002. EXEMPTIONS. This chapter does not apply to:
(1) a medical or dental school or an outpatient clinic
associated with a medical or dental school;
(2) a hospital, including any outpatient facility or
clinic of a hospital;
(3) a hospice established under 40 T.A.C. Section
97.403 or defined by 42 C.F.R. Section 418.3;
(4) a facility maintained or operated by this state;
(5) a clinic maintained or operated by the United
States;
(6) a health organization certified by the board under
Section 162.001; or
(7) a clinic owned or operated by a physician who
treats patients within the physician's area of specialty and who
uses other forms of treatment, including surgery, with the issuance
of a prescription for a majority of the patients.
[Sections 167.003-167.050 reserved for expansion]
SUBCHAPTER B. POWERS AND DUTIES OF BOARD
Sec. 167.051. ADOPTION OF RULES. The board shall adopt
rules necessary to implement this chapter, including rules to
address, for a pain management clinic:
(1) the operation of the clinic;
(2) personnel requirements for the clinic, including
requirements for a physician who practices at a clinic;
(3) standards to ensure quality of patient care;
(4) certificate application and renewal procedures
and requirements;
(5) inspections and complaint investigations; and
(6) patient billing procedures.
Sec. 167.052. INSPECTIONS. The board may inspect a pain
management clinic, including the documents of a physician
practicing at the clinic, as necessary to ensure compliance with
this chapter.
Sec. 167.053. COMPLAINTS. The board shall investigate a
complaint alleging a violation of this chapter or a rule adopted
under this chapter by a pain management clinic certified under this
chapter or a physician who owns or operates a clinic in the same
manner as other complaints under this subtitle.
[Sections 167.054-167.100 reserved for expansion]
SUBCHAPTER C. CERTIFICATION OF CLINIC
Sec. 167.101. CERTIFICATE REQUIRED. (a) A pain management
clinic may not operate in this state unless the clinic is certified
under this chapter.
(b) A certificate issued under this chapter is not
transferable or assignable.
Sec. 167.102. CERTIFICATE APPLICATION AND ISSUANCE. (a) A
physician who owns or operates a pain management clinic shall apply
for a certificate for the clinic under this chapter. A pain
management clinic must be owned and operated by a medical director
who is a physician who practices in this state under an unrestricted
license.
(b) An applicant for a certificate under this chapter must
submit an application to the board on a form prescribed by the
board.
(c) The board shall issue a certificate if the board finds
that the pain management clinic meets the requirements of this
chapter and the standards adopted by the board under this chapter.
[Sections 167.103-167.150 reserved for expansion]
SUBCHAPTER D. CERTIFICATE RENEWAL
Sec. 167.151. EXPIRATION OF CERTIFICATE. (a) A
certificate issued under this chapter expires on the second
anniversary of the date it is issued.
(b) The board shall grant a 180-day grace period from the
expiration date of a certificate to renew the certificate.
(c) The owner or operator of a pain management clinic for
which a certificate has expired may not continue to operate the
clinic until the clinic's certificate is renewed.
Sec. 167.152. REQUIREMENTS FOR RENEWAL. (a) The owner or
operator of a pain management clinic may apply to renew a
certificate issued to the clinic under this chapter by:
(1) submitting a renewal application to the board on
the form prescribed by the board before the expiration of the grace
period under Section 167.151; and
(2) complying with any other requirements adopted by
board rule.
(b) If a certificate is not renewed before the expiration of
the grace period under Section 167.151, the pain management clinic
must reapply for an original certificate to operate the clinic.
[Sections 167.153-167.200 reserved for expansion]
SUBCHAPTER E. REGULATION OF CLINICS; ENFORCEMENT
Sec. 167.201. REGULATION OF PERSON AFFILIATED WITH CLINIC.
(a) The owner or operator of a pain management clinic, an employee
of the clinic, or a person with whom a clinic contracts for services
may not:
(1) have been denied, by any jurisdiction, a license
under which the person may prescribe, dispense, administer, supply,
or sell a controlled substance;
(2) have held a license issued by any jurisdiction,
under which the person may prescribe, dispense, administer, supply,
or sell a controlled substance, that has been restricted; or
(3) have been subject to disciplinary action by any
licensing entity for conduct that was a result of inappropriately
prescribing, dispensing, administering, supplying, or selling a
controlled substance.
(b) A pain management clinic may not be owned wholly or
partly by a person who has been convicted of or pled nolo contendere
to:
(1) an offense that constitutes a felony; or
(2) an offense that constitutes a misdemeanor, the
facts of which relate to the distribution of illegal prescription
drugs or a controlled substance as defined by Section 551.003(11).
(c) The owner or operator of a pain management clinic shall:
(1) be on-site at the clinic at least 33 percent of the
clinic's total number of operating hours; and
(2) review at least 33 percent of the total number of
patient files of the clinic, including the patient files of a clinic
employee or contractor to whom authority for patient care has been
delegated by the clinic.
Sec. 167.202. DISCIPLINARY ACTION. (a) A violation of
this chapter or a rule adopted under this chapter is grounds for
disciplinary action against a pain management clinic certified
under this chapter or an owner or operator of a clinic certified
under this chapter.
(b) A violation of this chapter may be enforced in the same
manner as any other violation of this subtitle.
SECTION 2. (a) Not later than March 1, 2010, the Texas
Medical Board shall adopt the rules required by Chapter 167,
Occupations Code, as added by this Act.
(b) Notwithstanding Section 167.101, Occupations Code, as
added by this Act, a pain management clinic must obtain a
certificate required by that section not later than September 1,
2010.
SECTION 3. (a) Except as provided by Subsection (b) of
this section, this Act takes effect September 1, 2009.
(b) Section 167.101, Occupations Code, as added by this Act,
takes effect September 1, 2010.
* * * * *