| 1 | 1 | | 83R15096 JSL-F |
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| 2 | 2 | | By: Goldman, Callegari H.B. No. 2158 |
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| 3 | 3 | | Substitute the following for H.B. No. 2158: |
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| 4 | 4 | | By: Zedler C.S.H.B. No. 2158 |
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| 5 | 5 | | |
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| 6 | 6 | | |
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| 7 | 7 | | A BILL TO BE ENTITLED |
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| 8 | 8 | | AN ACT |
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| 9 | 9 | | relating to the period of ineligibility from participation in the |
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| 10 | 10 | | Medicaid program by providers found liable for certain unlawful |
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| 11 | 11 | | acts under the program. |
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| 12 | 12 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 13 | 13 | | SECTION 1. Section 36.005, Human Resources Code, is amended |
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| 14 | 14 | | by amending Subsection (b-1) and adding Subsections (b-3) and (f) |
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| 15 | 15 | | to read as follows: |
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| 16 | 16 | | (b-1) The period of ineligibility begins on the date on |
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| 17 | 17 | | which a trial court enters a judgment finding the provider liable |
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| 18 | 18 | | under Section 36.052 [the determination that the provider is liable |
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| 19 | 19 | | becomes final]. |
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| 20 | 20 | | (b-3) Notwithstanding Subsection (b-1), the period of |
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| 21 | 21 | | ineligibility for a physician, a physician organization, or an |
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| 22 | 22 | | individual licensed by a health care regulatory agency begins on |
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| 23 | 23 | | the date on which the determination that the physician, physician |
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| 24 | 24 | | organization, or individual is liable becomes final and all appeals |
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| 25 | 25 | | relating to that determination are exhausted or waived. |
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| 26 | 26 | | (f) For purposes of Subsection (b-3): |
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| 27 | 27 | | (1) "Health care regulatory agency" has the meaning |
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| 28 | 28 | | assigned by Section 774.001, Government Code. |
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| 29 | 29 | | (2) "Physician organization" means: |
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| 30 | 30 | | (A) a professional association composed solely |
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| 31 | 31 | | of physicians; |
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| 32 | 32 | | (B) a single legal entity authorized to practice |
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| 33 | 33 | | medicine in this state and owned by two or more physicians; |
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| 34 | 34 | | (C) a nonprofit health corporation certified |
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| 35 | 35 | | under Chapter 162, Occupations Code; or |
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| 36 | 36 | | (D) a partnership composed solely of physicians. |
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| 37 | 37 | | SECTION 2. If before implementing any provision of this Act |
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| 38 | 38 | | a state agency determines that a waiver or authorization from a |
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| 39 | 39 | | federal agency is necessary for implementation of that provision, |
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| 40 | 40 | | the agency affected by the provision shall request the waiver or |
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| 41 | 41 | | authorization and may delay implementing that provision until the |
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| 42 | 42 | | waiver or authorization is granted. |
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| 43 | 43 | | SECTION 3. This Act takes effect September 1, 2013. |
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