Texas 2011 - 82nd Regular

Texas Senate Bill SB1661 Compare Versions

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1	1	By: Duncan S.B. No. 1661
2	2	(Hunter)
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the regulation of health organizations certified by the
8	8	Texas Medical Board; imposing an administrative penalty.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subchapter A, Chapter 162, Occupations Code, is
11	11	amended by adding Sections 162.0021, 162.0022, 162.0023, and
12	12	162.0024 to read as follows:
13	13	Sec. 162.0021. INTERFERENCE WITH PHYSICIAN'S PROFESSIONAL
14	14	JUDGMENT PROHIBITED. A health organization certified under Section
15	15	162.001(b) may not interfere with, control, or otherwise direct a
16	16	physician's professional judgment in violation of this subchapter
17	17	or any other provision of law, including board rules.
18	18	Sec. 162.0022. HEALTH ORGANIZATION POLICIES. (a) A health
19	19	organization certified under Section 162.001(b) shall adopt,
20	20	maintain, and enforce policies to ensure that a physician employed
21	21	by the health organization exercises independent medical judgment
22	22	when providing care to patients.
23	23	(b) The policies adopted under this section must include
24	24	policies relating to:
25	25	(1) credentialing;
26	26	(2) quality assurance;
27	27	(3) utilization review; and
28	28	(4) peer review.
29	29	(c) The policies adopted under this section, including any
30	30	amendments to the policies, must be developed by the board of
31	31	directors or board of trustees, as applicable, of the health
32	32	organization and approved by an affirmative vote.
33	33	(d) The policies of the health organization must be drafted
34	34	and interpreted in a manner that reserves the sole authority to
35	35	engage in the practice of medicine to a physician participating in
36	36	the health organization, regardless of the physician's employment
37	37	status with the health organization.
38	38	Sec. 162.0023. DISCIPLINARY ACTION RESTRICTION. A
39	39	physician employed by a health organization certified under Section
40	40	162.001(b) retains independent medical judgment in providing care
41	41	to patients, and the health organization may not discipline the
42	42	physician for reasonably advocating for patient care.
43	43	Sec. 162.0024. CONTRACTUAL WAIVER PROHIBITED. (a) The
44	44	requirements of this subchapter may not be voided or waived by
45	45	contract.
46	46	(b) Notwithstanding Subsection (a), a member of a health
47	47	organization certified under Section 162.001(b) may establish
48	48	ethical and religious directives and a physician may contractually
49	49	agree to comply with those directives.
50	50	SECTION 2. Section 162.003, Occupations Code, is amended to
51	51	read as follows:
52	52	Sec. 162.003. REFUSAL TO CERTIFY; REVOCATION; PENALTY. On
53	53	a determination that a health organization is established,
54	54	organized, or operated in violation of or with the intent to violate
55	55	this subtitle, the board may:
56	56	(1) [may] refuse to certify the health organization on
57	57	application for certification by the organization under Section
58	58	162.001; [and]
59	59	(2) [shall] revoke a certification made under Section
60	60	162.001 to that organization; or
61	61	(3) impose an administrative penalty against the
62	62	health organization under Subchapter A, Chapter 165.
63	63	SECTION 3. (a) Except as provided by Subsection (b) of
64	64	this section, this Act takes effect September 1, 2011.
65	65	(b) Section 162.0022, Occupations Code, as added by this
66	66	Act, takes effect January 1, 2012.