By: Kokhorst, Raymond (Senate Sponsor - Nelson) H.B. No. 3556
(In the Senate - Received from the House May 6, 2013;
May 7, 2013, read first time and referred to Committee on Health
and Human Services; May 16, 2013, reported adversely, with
favorable Committee Substitute by the following vote: Yeas 7,
Nays 0; May 16, 2013, sent to printer.)
COMMITTEE SUBSTITUTE FOR H.B. No. 3556 By: Nelson
A BILL TO BE ENTITLED
AN ACT
relating to the licensing and regulation of emergency medical
services providers and a moratorium on the issuance of emergency
medical services provider licenses.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 773.0571, Health and Safety Code, is
amended to read as follows:
Sec. 773.0571. REQUIREMENTS FOR PROVIDER LICENSE. The
department shall issue to an emergency medical services provider
applicant a license that is valid for two years if the department is
satisfied that:
(1) the applicant [emergency medical services
provider] has adequate staff to meet the staffing standards
prescribed by this chapter and the rules adopted under this
chapter;
(2) each emergency medical services vehicle is
adequately constructed, equipped, maintained, and operated to
render basic or advanced life support services safely and
efficiently;
(3) the applicant [emergency medical services
provider] offers safe and efficient services for emergency
prehospital care and transportation of patients; [and]
(4) the applicant:
(A) possesses sufficient professional experience
and qualifications to provide emergency medical services; and
(B) has not been excluded from participation in
the state Medicaid program;
(5) the applicant holds a letter of approval issued
under Section 773.0573 by the governing body of the municipality or
the commissioners court of the county in which the applicant is
located and is applying to provide emergency medical services, as
applicable; and
(6) the applicant [emergency medical services
provider] complies with the rules adopted [by the board] under this
chapter.
SECTION 2. Subchapter C, Chapter 773, Health and Safety
Code, is amended by adding Sections 773.05711, 773.05712, and
773.05713 to read as follows:
Sec. 773.05711. ADDITIONAL EMERGENCY MEDICAL SERVICES
PROVIDER LICENSE REQUIREMENTS. (a) In addition to the
requirements for obtaining or renewing an emergency medical
services provider license under this subchapter, a person who
applies for a license or for a renewal of a license must:
(1) provide the department with a letter of credit
issued by a federally insured bank or savings institution in the
amount of:
(A) $100,000 for the initial license and for
renewal of the license on the second anniversary of the date the
initial license is issued;
(B) $75,000 for renewal of the license on the
fourth anniversary of the date the initial license is issued;
(C) $50,000 for renewal of the license on the
sixth anniversary of the date the initial license is issued; and
(D) $25,000 for renewal of the license on the
eighth anniversary of the date the initial license is issued;
(2) if the applicant participates in the medical
assistance program operated under Chapter 32, Human Resources Code,
the Medicaid managed care program operated under Chapter 533,
Government Code, or the child health plan program operated under
Chapter 62 of this code, provide the Health and Human Services
Commission with a surety bond in the amount of $50,000; and
(3) submit for approval by the department the name and
contact information of the provider's administrator of record who
satisfies the requirements under Section 773.05712.
(b) An emergency medical services provider that is directly
operated by a governmental entity is exempt from this section.
Sec. 773.05712. ADMINISTRATOR OF RECORD. (a) The
administrator of record for an emergency medical services provider
licensed under this subchapter:
(1) may not be employed or otherwise compensated by
another private for-profit emergency medical services provider;
(2) must meet the qualifications required for an
emergency medical technician or other health care professional
license or certification issued by this state; and
(3) must submit to a criminal history record check at
the applicant's expense.
(b) Section 773.0415 does not apply to information an
administrator of record is required to provide under this section.
(c) An administrator of record initially approved by the
department may be required to complete an education course for new
administrators of record. The executive commissioner shall
recognize, prepare, or administer the education course for new
administrators of record, which must include information about the
laws and department rules that affect emergency medical services
providers.
(d) An administrator of record approved by the department
under Section 773.05711(a) annually must complete at least eight
hours of continuing education following initial approval. The
executive commissioner shall recognize, prepare, or administer
continuing education programs for administrators of record, which
must include information about changes in law and department rules
that affect emergency medical services providers.
(e) Subsection (a)(2) does not apply to an emergency medical
services provider that held a license on September 1, 2013, and has
an administrator of record who has at least eight years of
experience providing emergency medical services.
(f) An emergency medical services provider that is directly
operated by a governmental entity is exempt from this section.
Sec. 773.05713. REPORT TO LEGISLATURE. Not later than
December 1 of each even-numbered year, the department shall
electronically submit a report to the lieutenant governor, the
speaker of the house of representatives, and the standing
committees of the house and senate with jurisdiction over the
department on the effect of Sections 773.05711 and 773.05712 that
includes:
(1) the total number of applications for emergency
medical services provider licenses submitted to the department and
the number of applications for which licenses were issued or
licenses were denied by the department;
(2) the number of emergency medical services provider
licenses that were suspended or revoked by the department for
violations of those sections and a description of the types of
violations that led to the license suspension or revocation;
(3) the number of occurrences and types of fraud
committed by licensed emergency medical services providers related
to those sections;
(4) the number of complaints made against licensed
emergency medical services providers for violations of those
sections and a description of the types of complaints; and
(5) the status of any coordination efforts of the
department and the Texas Medical Board related to those sections.
SECTION 3. Subchapter C, Chapter 773, Health and Safety
Code, is amended by adding Section 773.0573 to read as follows:
Sec. 773.0573. LETTER OF APPROVAL FROM LOCAL GOVERNMENTAL
ENTITY. (a) An emergency medical services provider applicant must
obtain a letter of approval from:
(1) the governing body of the municipality in which
the applicant is located and is applying to provide emergency
medical services; or
(2) if the applicant is not located in a municipality,
the commissioners court of the county in which the applicant is
located and is applying to provide emergency medical services.
(b) A governing body of a municipality or a commissioners
court of a county may issue a letter of approval to an emergency
medical services provider applicant who is applying to provide
emergency medical services in the municipality or county only if
the governing body or commissioners court determines that:
(1) the addition of another licensed emergency medical
services provider will not interfere with or adversely affect the
provision of emergency medical services by the licensed emergency
medical services providers operating in the municipality or county;
(2) the addition of another licensed emergency medical
services provider will remedy an existing provider shortage that
cannot be resolved through the use of the licensed emergency
medical services providers operating in the municipality or county;
and
(3) the addition of another licensed emergency medical
services provider will not cause an oversupply of licensed
emergency medical services providers in the municipality or county.
(c) An emergency medical services provider is prohibited
from expanding operations to or stationing any emergency medical
services vehicles in a municipality or county other than the
municipality or county from which the provider obtained the letter
of approval under this section until after the second anniversary
of the date the provider's initial license was issued, unless the
expansion or stationing occurs in connection with:
(1) a contract awarded by another municipality or
county for the provision of emergency medical services;
(2) an emergency response made in connection with an
existing mutual aid agreement; or
(3) an activation of a statewide emergency or disaster
response by the department.
(d) This section does not apply to:
(1) renewal of an emergency medical services provider
license; or
(2) a municipality, county, emergency services
district, hospital, or emergency medical services volunteer
provider organization in this state that applies for an emergency
medical services provider license.
SECTION 4. Subchapter C, Chapter 773, Health and Safety
Code, is amended by adding Section 773.06141 to read as follows:
Sec. 773.06141. SUSPENSION, REVOCATION, OR DENIAL OF
EMERGENCY MEDICAL SERVICES PROVIDER LICENSE. (a) The commissioner
may suspend, revoke, or deny an emergency medical services provider
license on the grounds that the provider's administrator of record,
employee, or other representative:
(1) has been convicted of, or placed on deferred
adjudication community supervision or deferred disposition for, an
offense that directly relates to the duties and responsibilities of
the administrator, employee, or representative, other than an
offense for which points are assigned under Section 708.052,
Transportation Code;
(2) has been convicted of or placed on deferred
adjudication community supervision or deferred disposition for an
offense, including:
(A) an offense listed in Sections 3g(a)(1)(A)
through (H), Article 42.12, Code of Criminal Procedure; or
(B) an offense, other than an offense described
by Subdivision (1), for which the person is subject to registration
under Chapter 62, Code of Criminal Procedure; or
(3) has been convicted of Medicare or Medicaid fraud,
has been excluded from participation in the state Medicaid program,
or has a hold on payment for reimbursement under the state Medicaid
program under Subchapter C, Chapter 531, Government Code.
(b) An emergency medical services provider that is directly
operated by a governmental entity is exempt from this section.
SECTION 5. Section 773.0571, Health and Safety Code, as
amended by this Act, and Section 773.0573, Health and Safety Code,
as added by this Act, apply only to an application for approval of
an emergency medical services provider license submitted to the
Department of State Health Services on or after the effective date
of this Act. An application submitted before the effective date of
this Act is governed by the law in effect immediately before the
effective date of this Act, and that law is continued in effect for
that purpose.
SECTION 6. The change in law made by this Act applies only
to an application for approval or renewal of an emergency medical
services provider license submitted to the Department of State
Health Services on or after the effective date of this Act. An
application submitted before the effective date of this Act is
governed by the law in effect immediately before the effective date
of this Act, and that law is continued in effect for that purpose.
SECTION 7. This Act takes effect September 1, 2013.
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