Texas 2011 - 82nd Regular

Texas House Bill HB1809 Compare Versions

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1	1	82R23747 YDB-F
2	2	By: Thompson, et al. H.B. No. 1809
3	3	Substitute the following for H.B. No. 1809:
4	4	By: Kuempel C.S.H.B. No. 1809
5	5
6	6
7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to the registration of diagnostic imaging equipment, the
10	10	accreditation of diagnostic imaging facilities, and the regulation
11	11	of diagnostic imaging providers; providing penalties.
12	12	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
13	13	SECTION 1. Subtitle A, Title 3, Occupations Code, is
14	14	amended by adding Chapter 113 to read as follows:
15	15	CHAPTER 113. DIAGNOSTIC IMAGING
16	16	SUBCHAPTER A. GENERAL PROVISIONS
17	17	Sec. 113.001. DEFINITIONS. In this chapter:
18	18	(1) "Department" means the Department of State Health
19	19	Services.
20	20	(2) "Diagnostic imaging equipment" means a machine or
21	21	equipment used to provide a diagnostic imaging service to a
22	22	patient.
23	23	(3) "Diagnostic imaging facility" means any facility,
24	24	office, clinic, imaging center, hospital, or other location where a
25	25	diagnostic imaging service is provided to a patient for a fee.
26	26	(4) "Diagnostic imaging provider" means a health care
27	27	provider who performs a diagnostic imaging service on a patient for
28	28	a fee at a diagnostic imaging facility.
29	29	(5) "Diagnostic imaging service" means magnetic
30	30	resonance imaging, computed tomography, positron emission
31	31	tomography, or any hybrid technology that combines any of those
32	32	imaging modalities.
33	33	(6) "Health care provider" means a physician licensed
34	34	under Subtitle B, Title 3, or a nurse licensed under Subtitle E,
35	35	Title 3.
36	36	(7) "Patient" means a person who receives a physical
37	37	examination, evaluation, diagnosis, or treatment from a health care
38	38	provider.
39	39	(8) "Referral" means a health care provider's request
40	40	for or ordering of a diagnostic imaging service for a patient. The
41	41	term does not include a request for or ordering of nondiagnostic
42	42	imaging obtained for the sole purpose of direct incorporation into
43	43	treatment planning systems in the delivery of radiation therapy.
44	44	Sec. 113.002. RULES. The executive commissioner of the
45	45	Health and Human Services Commission, on behalf of the department
46	46	and as necessary to protect the public health and safety, shall
47	47	adopt rules specifying the procedures health care providers and
48	48	diagnostic imaging providers must use to comply with this chapter.
49	49	Sec. 113.003. SAFETY STANDARDS. Notwithstanding any other
50	50	law, a person who operates a diagnostic imaging facility that is
51	51	registered under this chapter or is exempt from registration under
52	52	this chapter may adopt and enforce safety standards that conform to
53	53	the recommendations of the American College of Radiology's ACR
54	54	Guidance Document for Safe MR Practices as the document existed on
55	55	January 1, 2011, or a more current version of the document approved
56	56	by the department.
57	57	[Sections 113.004-113.050 reserved for expansion]
58	58	SUBCHAPTER B. REGISTRATION OF FACILITIES
59	59	Sec. 113.051. REGISTRATION REQUIRED. Except as provided by
60	60	Section 113.052, a person may not operate a diagnostic imaging
61	61	facility in this state without a diagnostic imaging facility
62	62	certificate of registration issued under this subchapter.
63	63	Sec. 113.052. EXEMPTIONS FROM REGISTRATION REQUIREMENT.
64	64	The following facilities are not required to be registered under
65	65	this chapter:
66	66	(1) a birthing center licensed under Chapter 244,
67	67	Health and Safety Code;
68	68	(2) a hospital licensed under Chapter 241, Health and
69	69	Safety Code;
70	70	(3) a hospital owned and operated by this state;
71	71	(4) a diagnostic imaging facility located within or
72	72	connected to a hospital described by Subdivision (2) or (3);
73	73	(5) a diagnostic imaging facility owned or operated by
74	74	a hospital described by Subdivision (2) or (3) that is:
75	75	(A) surveyed as a service of the hospital by an
76	76	organization that has been granted deeming authority as a national
77	77	accreditation program for hospitals by the Centers for Medicare and
78	78	Medicaid Services; or
79	79	(B) granted provider-based status by the Centers
80	80	for Medicare and Medicaid Services; and
81	81	(6) a diagnostic imaging facility that uses only
82	82	dedicated dental diagnostic technology, which may include
83	83	cone-beam computed tomography used only to obtain images of the
84	84	maxillofacial region.
85	85	Sec. 113.053. APPLICATION; ISSUANCE. (a) An applicant for
86	86	a diagnostic imaging facility certificate of registration shall
87	87	submit to the department an application on the form prescribed by
88	88	the department.
89	89	(b) The department shall issue a diagnostic imaging
90	90	facility certificate of registration to an applicant if:
91	91	(1) the applicant pays any required fee; and
92	92	(2) the department determines the applicant's facility
93	93	meets the accreditation requirements under Section 113.054 and
94	94	department rule.
95	95	Sec. 113.054. ACCREDITATION OF FACILITIES. (a) The
96	96	department may not issue a diagnostic imaging facility certificate
97	97	of registration to a person unless the person's diagnostic imaging
98	98	facility has been accredited by a nationally recognized
99	99	accreditation organization approved by the department.
100	100	(b) In approving accreditation organizations, the
101	101	department shall consider:
102	102	(1) the ability of the organization to conduct timely
103	103	reviews of accreditation applications;
104	104	(2) the organization's process for timely integration
105	105	of new technology into accreditation programs;
106	106	(3) whether the organization's criteria for
107	107	accreditation of diagnostic imaging facilities includes all of the
108	108	following:
109	109	(A) qualifications for health care providers and
110	110	medical personnel providing health care services at the facility;
111	111	(B) qualifications for and responsibilities of
112	112	medical directors, supervising health care providers, and
113	113	interpreting health care providers providing services at the
114	114	facility;
115	115	(C) procedures for ensuring that diagnostic
116	116	imaging equipment complies with established performance
117	117	specifications, such as an independent assessment of image quality
118	118	and dose and an annual survey by a medical physicist that includes
119	119	dose measurements;
120	120	(D) procedures for ensuring that the images
121	121	produced by the equipment are of diagnostic quality, including
122	122	through direct visual evaluation of representative images by a
123	123	physician trained in medical imaging;
124	124	(E) procedures for ensuring patient safety; and
125	125	(F) quality assurance reporting; and
126	126	(4) any other factors the department considers
127	127	necessary to protect the health and safety of facility patients and
128	128	the public.
129	129	(c) Notwithstanding Subsections (a) and (b), the department
130	130	shall issue a diagnostic imaging facility certificate of
131	131	registration to a person who operates a diagnostic imaging facility
132	132	accredited by a nationally recognized accreditation organization
133	133	accepted by the Centers for Medicare and Medicaid Services if the
134	134	department determines the organization's accreditation criteria
135	135	meet all department requirements.
136	136	Sec. 113.055. TERM; RENEWAL. (a) A diagnostic imaging
137	137	facility certificate of registration expires on the second
138	138	anniversary of the date of issuance.
139	139	(b) A person may renew a diagnostic imaging facility
140	140	certificate of registration by submitting to the department on the
141	141	form prescribed by the department a renewal application and any fee
142	142	required by the department.
143	143	[Sections 113.056-113.070 reserved for expansion]
144	144	SUBCHAPTER B-1. REPORTING AND DISCLOSURE OF HEALTH CARE PROVIDER
145	145	REFERRALS
146	146	Sec. 113.071. DEFINITIONS. In this subchapter:
147	147	(1) "Immediate family member" means a person's spouse,
148	148	child, child's spouse, grandchild, grandchild's spouse, parent,
149	149	parent-in-law, or sibling.
150	150	(2) "Investment interest" means:
151	151	(A) an equity or debt security issued by a
152	152	person, including:
153	153	(i) shares of stock in a corporation;
154	154	(ii) membership or other interest in a
155	155	company, including a limited liability company;
156	156	(iii) units or other interests in a
157	157	partnership, including a limited liability partnership; and
158	158	(iv) bonds, debentures, notes, or other
159	159	equity interests or debt instruments; and
160	160	(B) the rental or time sharing of imaging
161	161	equipment and office space in which a referring health care
162	162	provider receives a portion of the billing revenue.
163	163	(3) "Investor" means a person who directly or
164	164	indirectly holds a legal, beneficial ownership, or investment
165	165	interest, including an interest held through an immediate family
166	166	member, a trust, or another person related to the investor within
167	167	the meaning of "related to the provider" as defined by 42 C.F.R.
168	168	Section 413.17.
169	169	(4) "Licensing authority" means a department, board,
170	170	office, or other agency of this state that regulates a health care
171	171	provider subject to this chapter.
172	172	Sec. 113.072. REPORTING AND DISCLOSURE OF REFERRALS. A
173	173	health care provider making a referral for diagnostic imaging
174	174	services must:
175	175	(1) disclose in writing to the provider's patients the
176	176	provider's investment interest in the diagnostic imaging facility;
177	177	(2) advise the provider's patients that the patient
178	178	may choose to have another diagnostic imaging facility provide the
179	179	diagnostic imaging services; and
180	180	(3) obtain and record the patient's written consent
181	181	after the disclosure and before the diagnostic imaging services are
182	182	provided.
183	183	[Sections 113.073-113.100 reserved for expansion]
184	184	SUBCHAPTER C. CIVIL PENALTY
185	185	Sec. 113.101. CIVIL PENALTY. (a) A person who operates a
186	186	diagnostic imaging facility or a diagnostic imaging provider that
187	187	violates this chapter or rules adopted under this chapter is
188	188	subject to a civil penalty of not more than $1,000 for each
189	189	violation.
190	190	(b) The attorney general at the request of the department
191	191	shall bring an action to collect penalties under this section. In
192	192	the suit, the department and the attorney general each may recover
193	193	reasonable expenses incurred in obtaining the penalty, including:
194	194	(1) investigation and court costs; and
195	195	(2) reasonable attorney's fees, witness fees, and
196	196	deposition expenses.
197	197	(c) Expenses recovered by the department under this section
198	198	shall be deposited in a separate account outside the state treasury
199	199	to be used by the department in the enforcement of this chapter.
200	200	SECTION 2. (a) Not later than January 1, 2012, the
201	201	executive commissioner of the Health and Human Services Commission
202	202	shall adopt the rules necessary to implement Chapter 113,
203	203	Occupations Code, as added by this Act.
204	204	(b) Notwithstanding Chapter 113, Occupations Code, as added
205	205	by this Act, a person is not required to hold a diagnostic imaging
206	206	facility certificate of registration to operate a diagnostic
207	207	imaging facility until March 1, 2012.
208	208	SECTION 3. Subchapter B-1, Chapter 113, Occupations Code,
209	209	as added by this Act, applies only to a referral or diagnostic
210	210	imaging service that occurs on or after the effective date of this
211	211	Act. A referral or service that occurs before the effective date of
212	212	this Act is governed by the law as it existed immediately before the
213	213	effective date of this Act, and that law is continued in effect for
214	214	that purpose.
215	215	SECTION 4. This Act takes effect September 1, 2011.