H.B. No. 3556 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. ______________________________ ______________________________ President of the Senate Speaker of the House I certify that H.B. No. 3556 was passed by the House on May 3, 2013, by the following vote: Yeas 126, Nays 2, 1 present, not voting; and that the House concurred in Senate amendments to H.B. No. 3556 on May 24, 2013, by the following vote: Yeas 139, Nays 3, 3 present, not voting. ______________________________ Chief Clerk of the House I certify that H.B. No. 3556 was passed by the Senate, with amendments, on May 22, 2013, by the following vote: Yeas 31, Nays 0. ______________________________ Secretary of the Senate APPROVED: __________________ Date __________________ Governor