By: Naishtat H.B. No. 3687
A BILL TO BE ENTITLED
AN ACT
relating to the provision of and funding for certain primary health
care services.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subdivisions (1), (3), and (4), Subsection (a),
Section 31.002, Health and Safety Code, are amended to read as
follows:
(1) "Facility" includes an entity providing primary [a
hospital, ambulatory surgical center, public health clinic,
birthing center, outpatient clinic, and community] health care
services [center].
(3) "Other benefit" means a benefit, other than a
benefit provided under this chapter, to which an individual is
entitled for payment of the costs of primary health care services,
including benefits available from:
(A) an insurance policy, group health plan, or
prepaid medical care plan;
(B) Title XVIII, [or] XIX, or XXI of the Social
Security Act (42 U.S.C. Section 1395 et seq., [or] Section 1396 et
seq., or Section 1397aa et seq.);
(C) [the Veterans Administration;
[(D) the Civilian Health and Medical Program of
the Uniformed Services;
[(E) workers' compensation or any other
compulsory employers' insurance program;
[(F)] a public program created by federal or
state law, or by an ordinance or rule of a municipality or political
subdivision of the state, excluding benefits created by the
establishment of a municipal or county hospital, a joint
municipal-county hospital, a county hospital authority, a hospital
district, or the facilities of a publicly supported medical school;
or
[(G) a cause of action for medical, facility, or
medical transportation expenses, or a settlement or judgment based
on the cause of action, if the expenses are related to the need for
services provided under this chapter].
(4) "Primary health care services" may include
[includes]:
(A) a health service related to family, internal,
pediatric, obstetric, or gynecological medicine that is provided by
a physician, physician assistant, or advanced practice registered
nurse [diagnosis and treatment];
(B) diagnostic laboratory and radiological
services;
(C) emergency medical services;
(D) [(C)] family planning services;
(E) [(D)] preventive health services, including:
(i) prenatal and perinatal services;
(ii) appropriate cancer screening;
(iii) well-child services;
(iv) immunizations against diseases that
are preventable by vaccines;
(v) screenings for elevated blood levels,
communicable diseases, and cholesterol levels;
(vi) pediatric eye, ear, and dental
screenings to determine the need for vision and hearing correction
and dental care; and
(vii) preventive dental services;
(F) [(E)] health education;
[(F) laboratory, X-ray, nuclear medicine, or
other appropriate diagnostic services;
[(G) nutrition services;
[(H) health screening;
[(I) home health care;
[(J) dental care;
[(K) transportation;]
(G) [(L)] prescription drugs and devices and
durable supplies, as appropriate; and
(H) integrated mental health services
[(M) environmental health services;
[(N) podiatry services; and
[(O) social services].
SECTION 2. Subsections (c), (d), (e), (f), and (g), Section
31.003, Health and Safety Code, are amended to read as follows:
(c) If budgetary limitations exist, the department [board
by rule] shall establish a system of priorities relating to the
types of services provided[, geographic areas covered,] or [classes
of] individuals eligible for services.
(d) The department [board] shall adopt rules under
Subsection (c) relating to the services provided [geographic areas
covered] and the [classes of] individuals eligible for services
[according to a statewide determination of the need for services].
(e) The department [board] shall adopt rules under
Subsection (c) relating to the types of services provided according
to the set of service priorities established under this subsection.
Initial service priorities shall focus on the funding of, provision
of, and access to:
(1) health services related to family, internal,
pediatric, obstetric, or gynecological medicine that is provided by
a physician, physician assistant, or advanced practice registered
nurse [diagnosis and treatment];
(2) emergency medical services;
(3) family planning services;
(4) preventive health services, including
immunizations;
(5) health education; and
(6) laboratory, X-ray, [nuclear medicine,] or other
appropriate diagnostic services.
(f) Except as limited by this section, the department shall
develop an integrated framework for the equitable provision of
services throughout the state and shall use existing public and
private health[, transportation, and education] resources.
(g) The department shall ensure that contractors have made,
will make, and will continue to make every reasonable effort to
collect appropriate reimbursement for its costs in providing
primary health care services to persons who are entitled to receive
other benefits the [board should require that the services provided
under this chapter be reserved to the greatest extent possible for
low-income individuals who are not eligible for similar services
through any other publicly funded program].
SECTION 3. Subsection (a), Section 31.012, Health and
Safety Code, is amended to read as follows:
(a) The department [board] may authorize [charge fees for
the services provided directly by the department or through]
approved providers to charge a copayment for services provided in
accordance with Subchapter D, Chapter 12.
SECTION 4. This Act takes effect September 1, 2013.