82R8165 YDB-F
By: Thompson H.B. No. 1809
A BILL TO BE ENTITLED
AN ACT
relating to the registration of diagnostic imaging equipment, the
accreditation of diagnostic imaging facilities, and the regulation
of diagnostic imaging providers; providing penalties.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle A, Title 3, Occupations Code, is
amended by adding Chapter 113 to read as follows:
CHAPTER 113. DIAGNOSTIC IMAGING
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 113.001. DEFINITIONS. In this chapter:
(1) "Department" means the Department of State Health
Services.
(2) "Diagnostic imaging equipment" means a machine or
equipment used to provide a diagnostic imaging service to a
patient.
(3) "Diagnostic imaging facility" means any facility,
office, clinic, imaging center, hospital, or other location where a
diagnostic imaging service is provided to a patient for a fee.
(4) "Diagnostic imaging provider" means a health care
provider who performs a diagnostic imaging service on a patient for
a fee at a diagnostic imaging facility.
(5) "Diagnostic imaging service" means magnetic
resonance imaging, computed tomography, positron emission
tomography, or any hybrid technology that combines any of those
imaging modalities.
(6) "Health care provider" means a person licensed as
a health care professional or authorized to practice in health care
under Subtitle B, C, or E.
(7) "Patient" means a person who receives a physical
examination, evaluation, diagnosis, or treatment from a health care
provider.
(8) "Referral" means a health care provider's request
for or ordering of a diagnostic imaging service for a patient.
Sec. 113.002. RULES. The executive commissioner of the
Health and Human Services Commission, on behalf of the department
and as necessary to protect the public health and safety, shall
adopt rules specifying the procedures health care providers and
diagnostic imaging providers must use to comply with this chapter.
[Sections 113.003-113.050 reserved for expansion]
SUBCHAPTER B. REGISTRATION OF FACILITIES
Sec. 113.051. REGISTRATION REQUIRED. Except as provided by
Section 113.052, a person may not operate a diagnostic imaging
facility in this state unless the person holds a diagnostic imaging
facility certificate of registration issued under this subchapter.
Sec. 113.052. EXEMPTIONS FROM REGISTRATION REQUIREMENT.
The following facilities are not required to be registered under
this chapter:
(1) a birthing center licensed under Chapter 244,
Health and Safety Code; and
(2) a hospital licensed under Chapter 241, Health and
Safety Code.
Sec. 113.053. APPLICATION; ISSUANCE. (a) An applicant for
a diagnostic imaging facility certificate of registration shall
submit to the department an application on the form prescribed by
the department.
(b) The department shall issue a diagnostic imaging
facility certificate of registration to an applicant if:
(1) the applicant pays any required fee; and
(2) the department determines the applicant's facility
meets the accreditation requirements under Section 113.054 and
department rule.
Sec. 113.054. ACCREDITATION OF FACILITIES. (a) The
department may not issue a diagnostic imaging facility certificate
of registration to a person unless the person's diagnostic imaging
facility has been accredited by a nationally recognized
accreditation organization approved by the department.
(b) In approving accreditation organizations, the
department shall consider:
(1) the ability of the organization to conduct timely
reviews of accreditation applications;
(2) the organization's process for timely integration
of new technology into accreditation programs;
(3) whether the organization's criteria for
accreditation of diagnostic imaging facilities includes all of the
following:
(A) qualifications for health care providers and
medical personnel providing health care services at the facility;
(B) qualifications for and responsibilities of
medical directors, supervising health care providers, and
interpreting health care providers providing services at the
facility;
(C) procedures for ensuring that diagnostic
imaging equipment complies with established performance
specifications, such as an independent assessment of image quality
and dose and an annual survey by a medical physicist that includes
dose measurements;
(D) procedures for ensuring that the images
produced by the equipment are of diagnostic quality, including
through direct visual evaluation of representative images by a
physician trained in medical imaging;
(E) procedures for ensuring patient safety; and
(F) quality assurance reporting; and
(4) any other factors the department considers
necessary to protect the health and safety of facility patients and
the public.
Sec. 113.055. TERM; RENEWAL. (a) A diagnostic imaging
facility certificate of registration expires on the second
anniversary of the date of issuance.
(b) A person may renew a diagnostic imaging facility
certificate of registration by submitting to the department on the
form prescribed by the department a renewal application and any fee
required by the department.
[Sections 113.056-113.070 reserved for expansion]
SUBCHAPTER B-1. REPORTING AND DISCLOSURE OF HEALTH CARE PROVIDER
REFERRALS
Sec. 113.071. DEFINITIONS. In this subchapter:
(1) "Immediate family member" means a person's spouse,
child, child's spouse, grandchild, grandchild's spouse, parent,
parent-in-law, or sibling.
(2) "Investment interest" means:
(A) an equity or debt security issued by a
person, including:
(i) shares of stock in a corporation;
(ii) membership or other interest in a
company, including a limited liability company;
(iii) units or other interests in a
partnership, including a limited liability partnership; and
(iv) bonds, debentures, notes, or other
equity interests or debt instruments; and
(B) the rental or time sharing of imaging
equipment and office space in which a referring health care
provider receives a portion of the billing revenue.
(3) "Investor" means a person who directly or
indirectly holds a legal, beneficial ownership, or investment
interest, including an interest held through an immediate family
member, a trust, or another person related to the investor within
the meaning of "related to the provider" as defined by 42 C.F.R.
Section 413.17.
(4) "Licensing authority" means a department, board,
office, or other agency of this state that regulates a health care
provider subject to this chapter.
Sec. 113.072. REPORTING AND DISCLOSURE OF REFERRALS. (a)
In this section, "third party payor" means:
(1) a person authorized to engage in business
involving the payment of money or another thing of value in the
event of loss resulting from disability incurred as a result of
accident or sickness, as described in the Insurance Code;
(2) a health plan offered by an employer under the
provisions of the Employee Retirement Income Security Act of 1974
(29 U.S.C. Section 1001 et seq.);
(3) a publicly funded program of health care services,
including Medicaid or the state child health plan; or
(4) any person, other than a patient, that pays a
health care provider to provide designated health services or
supplies, including an insurance company or a health maintenance
organization.
(b) The owner or operator of a diagnostic imaging facility
that provides a diagnostic imaging service for a referring health
care provider shall report to the department:
(1) the identity of the referring health care
provider;
(2) whether the referring health care provider is an
investor in the diagnostic imaging facility and the exact nature of
any legal, beneficial ownership, or investment interest the
referring health care provider has in the diagnostic imaging
facility;
(3) the total number of patients who received
diagnostic imaging services at the diagnostic imaging facility and
who were referred by the health care provider; and
(4) the additional claims data required by the
department.
(c) A health care provider making a referral for diagnostic
imaging services as described by this section must:
(1) disclose in writing to the provider's patients and
any third party payor for a patient the provider's investment
interest in the diagnostic imaging facility;
(2) advise the provider's patients and any third party
payor for the patient that the patient may choose to have another
diagnostic imaging facility provide the diagnostic imaging
services; and
(3) obtain and record the patient's written consent
after the disclosure and before the diagnostic imaging services are
provided.
(d) The report required under Subsection (b) may be in the
form of a bill for services provided by the diagnostic imaging
facility in accordance with rules for filing a clean claim adopted
by the Texas Department of Insurance (28 T.A.C. Section 21.2803),
as those rules existed on September 1, 2011.
(e) A report required by this section must be submitted to
the department in the format or method required by the department.
Sec. 113.073. PUBLIC INFORMATION. Information collected
under Section 113.072(b) shall be made available to the public.
Sec. 113.074. DISCIPLINARY ACTION. A diagnostic imaging
facility's failure to report information required by this
subchapter is grounds for disciplinary action, including the
imposition of an administrative penalty, by the department.
[Sections 113.075-113.100 reserved for expansion]
SUBCHAPTER C. CIVIL PENALTY
Sec. 113.101. CIVIL PENALTY. (a) A person who operates a
diagnostic imaging facility or a diagnostic imaging provider that
violates this chapter or rules adopted under this chapter is
subject to a civil penalty of not more than $1,000 for each
violation.
(b) The attorney general at the request of the department
shall bring an action to collect penalties under this section. In
the suit, the department and the attorney general each may recover
reasonable expenses incurred in obtaining the penalty, including:
(1) investigation and court costs; and
(2) reasonable attorney's fees, witness fees, and
deposition expenses.
(c) Expenses recovered by the department under this section
shall be deposited in a separate account outside the state treasury
to be used by the department in the enforcement of this chapter.
SECTION 2. (a) The Department of State Health Services
shall conduct a study of the information required to be submitted to
the department under Subchapter B-1, Chapter 113, Occupations Code,
as added by this Act.
(b) In conducting the study, the department shall compare
the rates at which diagnostic imaging services were prescribed by
health care providers of the same specialty who have legal,
beneficial ownership, or investment interest in the diagnostic
imaging services prescribed for the patient's care and those who do
not have a legal, beneficial ownership, or investment interest in
the prescribed diagnostic imaging services.
(c) Not later than January 1, 2013, the department shall
submit a report regarding the study to the lieutenant governor and
the speaker of the house of representatives.
SECTION 3. (a) Not later than January 1, 2012, the
executive commissioner of the Health and Human Services Commission
shall adopt the rules necessary to implement Chapter 113,
Occupations Code, as added by this Act.
(b) Notwithstanding Chapter 113, Occupations Code, as added
by this Act, a person is not required to hold a diagnostic imaging
facility certificate of registration to operate a diagnostic
imaging facility until March 1, 2012.
SECTION 4. Subchapter B-1, Chapter 113, Occupations Code,
as added by this Act, applies only to a referral or diagnostic
imaging service that occurs on or after the effective date of this
Act. A referral or service that occurs before the effective date of
this Act is governed by the law as it existed immediately before the
effective date of this Act, and that law is continued in effect for
that purpose.
SECTION 5. This Act takes effect September 1, 2011.