H.B. No. 3201
AN ACT
relating to the practice of dentistry; imposing surcharges and
fees.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 254.004, Occupations Code, is amended by
adding Subsections (c) and (d) to read as follows:
(c) The board shall collect an additional $55 surcharge for
each of the following fees:
(1) the fee for the issuance of a dental license; and
(2) the fee for the renewal of a dental license.
(d) The board shall deposit each surcharge collected to the
credit of the dental public assurance account. The dental public
assurance account is an account in the general revenue fund that
shall be appropriated only to the board to pay for the board's
enforcement program, including an expert panel.
SECTION 2. Section 254.006(b), Occupations Code, is amended
to read as follows:
(b) Investigation files and other records are confidential,
except the board shall inform the license holder of the specific
allegations against the license holder [and shall be divulged only
to the persons investigated at the completion of the
investigation]. The board may share investigation files and other
records with another state regulatory agency or a local, state, or
federal law enforcement agency.
SECTION 3. Section 254.018, Occupations Code, is amended to
read as follows:
Sec. 254.018. [EXPERT] TESTIMONY. A member of the board may
not express an oral or written opinion or serve as an expert witness
in a civil action that is:
(1) related to an administrative matter within the
board's jurisdiction;
(2) brought [suit involving a health care liability
claim] against or for a person licensed or registered under this
subtitle; and
(3) [dentist] for the injury to or death of a patient
or for a violation of the standard of care or the commission of
malpractice [unless the member receives approval from the board or
an executive committee of the board to serve as an expert witness].
SECTION 4. Chapter 254, Occupations Code, is amended by
adding Section 254.019 to read as follows:
Sec. 254.019. DEFINITIONS. (a) In this section:
(1) "Dental service agreement" means an agreement
between a dental service organization and a dentist under which the
dental service organization will:
(A) provide services related to the nonclinical
business aspects of a dental practice, including arranging or
providing financing, performing billing or payroll tasks,
processing patient insurance claims, scheduling or otherwise
interacting with patients, and performing other administrative
tasks;
(B) supervise or manage the employees or
contractors of the dentist; or
(C) employ or otherwise contract with a dentist
in the dentist's capacity as a dentist.
(2) "Dental service organization" means an entity
that:
(A) is owned wholly or partly by a person who is
or is not a dentist; and
(B) under a dental service agreement, provides or
offers to provide services to a dentist or employs or otherwise
contracts with a dentist in the dentist's capacity as a dentist.
(b) The board shall collect the following information from
dentists licensed by the board in conjunction with the issuance and
renewal of each dental license:
(1) the number and type of dentists employed by the
license holder, if any;
(2) the name under which the license holder provides
dental services and each location at which those services are
provided by that license holder;
(3) whether the license holder is a participating
provider under the Medicaid program operated under Chapter 32,
Human Resources Code, or the child health plan program operated
under Chapter 62, Health and Safety Code;
(4) whether the license holder is employed by or
contracts with a dental service organization and, if so, the name
and address of the dental service organization;
(5) whether the license holder owns all or part of a
dental service organization and, if so, the name and address of the
dental service organization and of each dental office at which the
dental service organization provides services to patients;
(6) whether the license holder is a party to a dental
service agreement and, if so, the name and address of the dental
service organization that provides services under the agreement;
and
(7) if the license holder owns all or part of a dental
service organization, whether that practice is a party to a dental
service agreement and, if so, the name and address of the dental
service organization that provides services under the agreement.
(c) If requested by the board, a dental service organization
shall provide to the board the address of the locations where the
organization provides dental services in this state and the name of
each dentist providing dental services at each location.
(d) The board shall provide an option for the electronic
submission of the information required under this section.
(e) Not later than November 1 of each even-numbered year,
the board shall provide a report to the legislature on the
information collected under this section and on the board's use of
the information in the exercise of the board's statutory authority
to regulate the practice of dentistry.
SECTION 5. Sections 255.006(a) and (d-1), Occupations Code,
are amended to read as follows:
(a) A complaint received under this chapter must be filed
with and reviewed by the board to determine jurisdiction. If the
board has jurisdiction, the board shall complete a preliminary
investigation of the complaint not later than the 60th day after the
date of receiving [investigate the complaint to determine the facts
concerning] the complaint. The board shall first determine whether
the license holder constitutes a continuing threat to the public
welfare. On completion of the preliminary investigation, the board
shall determine whether to officially proceed on the complaint. If
the board fails to complete the preliminary investigation in the
time required by this subsection, the board's official
investigation of the complaint is considered to commence on that
date.
(d-1) Procedures established under Subsection (d)(6) must:
(1) [require a board employee to consult with a
dentist member of the board before dismissing a complaint relating
to patient morbidity, professional conduct, or quality of care;
[(2)] ensure that the decision to dismiss a complaint
is made with the appropriate level of review and necessary
expertise and experience; and
(2) [(3)] require the dismissal of a complaint to be
reported to the board at a public meeting of the board.
SECTION 6. Chapter 255, Occupations Code, is amended by
adding Sections 255.0065, 255.0066, and 255.0067 to read as
follows:
Sec. 255.0065. COMPOSITION OF EXPERT PANELS. (a) The board
by rule shall provide for expert panels appointed by the board to
assist with complaints and investigations relating to professional
competency by acting as expert dentist and dental hygienist
reviewers.
(b) Each member of the expert dentist panel must be licensed
to practice dentistry in this state. Each member of the expert
dental hygienist panel must be licensed to practice dental hygiene
in this state.
(c) The rules adopted under this section must include
provisions governing the composition of the panel, qualifications
for membership on the panel, length of time a member may serve on
the panel, grounds for removal from the panel, the avoidance of
conflicts of interest, including situations in which the affected
license holder and the panel member live or work in the same
geographical area or are competitors, and the duties to be
performed by the panel.
(d) The board's rules governing grounds for removal from the
panel must include providing for the removal of a panel member who
is repeatedly delinquent in reviewing complaints and in submitting
reports to the board.
Sec. 255.0066. DETERMINATION OF COMPETENCY. (a) If the
preliminary investigation under Section 255.006(a) indicates that
an act by a license holder falls below an acceptable standard of
care, the complaint shall be reviewed by an expert panel authorized
under Section 255.0065 consisting of license holders who practice
in the same specialty as the license holder who is the subject of
the complaint or in another specialty that is similar to the license
holder's specialty.
(b) The expert panel shall report in writing the panel's
determinations based on the review of the complaint under
Subsection (a). The report must specify the standard of care that
applies to the facts that are the basis of the complaint and the
clinical basis for the panel's determinations, including any
reliance on peer-reviewed journals, studies, or reports.
Sec. 255.0067. REPORTS; PROCEDURES FOR EXPERT REVIEW.
(a) A license holder on an expert panel authorized by Section
255.0065 who is initially selected to review a complaint shall:
(1) determine whether the license holder who is the
subject of the complaint has violated the standard of care
applicable to the circumstances; and
(2) issue a preliminary written report of that
determination.
(b) A second expert reviewer shall review the first expert
reviewer's preliminary report and other information associated
with the complaint. If the second reviewer agrees with the first
reviewer, the first reviewer shall issue a final written report on
the matter.
(c) If the second expert reviewer does not agree with the
conclusions of the first expert reviewer, a third expert reviewer
shall review the preliminary report and information and decide
between the conclusions reached by the first two reviewers. The
final written report shall be issued by the third reviewer or the
reviewer with whom the third reviewer concurs.
(d) In reviewing a complaint, the expert reviewers assigned
to examine the complaint may consult and communicate with each
other about the complaint in formulating their opinions and
reports.
SECTION 7. Subchapter C, Chapter 256, Occupations Code, is
amended by adding Section 256.106 to read as follows:
Sec. 256.106. DELEGATED AUTHORITY TO ISSUE LICENSES. The
board may delegate authority to board employees to issue licenses
under this subtitle to applicants who clearly meet all licensing
requirements. If the board employees determine that the applicant
does not clearly meet all licensing requirements, the application
shall be returned to the board. A license issued under this section
does not require formal board approval.
SECTION 8. Subchapter B, Chapter 258, Occupations Code, is
amended by adding Section 258.055 to read as follows:
Sec. 258.055. PRACTICE OF DENTISTRY ON CERTAIN CHILDREN.
(a) The parent or guardian of a child younger than 18 years of age
may be present in the treatment room during the child's dental
treatment or procedure, unless the dentist determines in the
dentist's professional judgment that the presence of the parent or
guardian in the treatment room is likely to have an adverse effect
on the treatment or the child.
(b) In this section, "parent or guardian" includes a person
authorized by law to consent for the medical or dental treatment of
a child younger than 18 years of age.
SECTION 9. Chapter 263, Occupations Code, is amended by
adding Sections 263.0065, 263.0076, and 263.0077 to read as
follows:
Sec. 263.0065. DELEGATION OF CERTAIN COMPLAINT
DISPOSITIONS. (a) The board may delegate to a committee of board
employees the authority to dismiss or enter into an agreed
settlement of a complaint that does not relate directly to patient
care or that involves only administrative violations.
(b) The disposition determined by the committee must be
approved by the board at a public meeting.
(c) A complaint delegated under this section shall be
referred for informal proceedings under Section 263.0075 if:
(1) the committee of employees determines that the
complaint should not be dismissed or settled;
(2) the committee is unable to reach an agreed
settlement; or
(3) the affected license holder requests that the
complaint be referred for informal proceedings.
Sec. 263.0076. INFORMAL SETTLEMENT CONFERENCE NOTICE. (a)
If an informal settlement conference will be held under Section
263.0075, notice of the time and place of the conference must be
given to the license holder not later than the 45th day before the
date the conference is held.
(b) The notice required by Subsection (a) must be
accompanied by a written statement of the specific allegations
against the license holder and the information the board intends to
use at the informal settlement conference. If the board does not
provide the statement or information when the notice is provided,
the license holder may use that failure as grounds for rescheduling
the conference.
(c) The license holder must provide to the board the license
holder's rebuttal not later than the 15th day before the date of the
conference in order for that information to be considered at the
conference.
(d) On request by a license holder under review, the board
shall make a recording of the informal settlement conference. The
recording is a part of the investigative file and may not be
released to a third party unless authorized under this subtitle.
The board may charge the license holder a fee to cover the cost of
recording the conference. The board shall provide a copy of the
recording to the license holder on the license holder's request.
Sec. 263.0077. REMEDIAL PLAN. (a) The board may issue and
establish the terms of a remedial plan to resolve the investigation
of a complaint filed under this subtitle.
(b) A remedial plan may not contain a provision that:
(1) revokes, suspends, limits, or restricts a person's
license or other authorization to practice dentistry or dental
hygiene; or
(2) assesses an administrative penalty against a
person.
(c) A remedial plan may not be imposed to resolve a
complaint:
(1) concerning:
(A) a patient death;
(B) the commission of a felony; or
(C) a matter in which the license holder engaged
in inappropriate sexual behavior or contact with a patient or
became financially or personally involved with a patient in an
inappropriate manner; or
(2) in which the appropriate resolution may involve a
restriction on the manner in which a license holder practices
dentistry or dental hygiene.
(d) The board may not issue a remedial plan to resolve a
complaint against a license holder if the license holder has
previously entered into a remedial plan with the board for the
resolution of a different complaint filed under this subtitle.
(e) The board may assess a fee against a license holder
participating in a remedial plan in an amount necessary to recover
the costs of administering the plan.
(f) A remedial plan is public information.
(g) In civil litigation, a remedial plan is a settlement
agreement under Rule 408, Texas Rules of Evidence.
(h) The board shall adopt rules necessary to implement this
section.
SECTION 10. Not later than December 1, 2013, the State Board
of Dental Examiners shall adopt rules necessary to implement the
changes in law made by this Act.
SECTION 11. Section 254.004(c), Occupations Code, as added
by this Act, applies only to an application for an original dental
license or for renewal of a dental license filed on or after
September 1, 2013. An application filed before September 1, 2013,
is governed by the law in effect immediately before that date, and
that law is continued in effect for that purpose.
SECTION 12. Sections 254.006(b) and 255.006, Occupations
Code, as amended by this Act, and Sections 255.0065, 255.0066,
255.0067, 263.0076, and 263.0077, Occupations Code, as added by
this Act, apply only to the investigation and resolution of a
complaint filed with the State Board of Dental Examiners on or after
January 1, 2014. A complaint filed before that date is governed by
the law in effect on the date the complaint was filed, and the
former law is continued in effect for that purpose.
SECTION 13. (a) Except as provided by Subsection (b) of
this section, this Act takes effect January 1, 2014.
(b) Section 10 of this Act and Sections 254.004(c) and (d)
and 254.019, Occupations Code, as added by this Act, take effect
September 1, 2013.
______________________________ ______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 3201 was passed by the House on May 3,
2013, by the following vote: Yeas 140, Nays 2, 1 present, not
voting; and that the House concurred in Senate amendments to H.B.
No. 3201 on May 22, 2013, by the following vote: Yeas 141, Nays 3,
2 present, not voting.
______________________________
Chief Clerk of the House
I certify that H.B. No. 3201 was passed by the Senate, with
amendments, on May 20, 2013, by the following vote: Yeas 31, Nays
0.
______________________________
Secretary of the Senate
APPROVED: __________________
Date
__________________
Governor