83R21547 AED-F
By: Naishtat H.B. No. 3687
Substitute the following for H.B. No. 3687:
By: Cortez C.S.H.B. No. 3687
A BILL TO BE ENTITLED
AN ACT
relating to the provision of and funding for certain primary health
care services; repealing a fee.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Sections 31.002(a)(1), (3), and (4), 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.); or
(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;
(G) [(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;
[(L)] prescription drugs and devices and durable
supplies, as appropriate;
[(M) environmental health services;
[(N) podiatry services;] and
(H) integrated mental health [(O) social]
services.
SECTION 2. Sections 31.003(c), (d), (e), (f), and (g),
Health and Safety Code, are amended to read as follows:
(c) The department [If budgetary limitations exist, the
board by rule] shall establish a system of priorities that includes
factors relating to the types of services provided, to the extent
possible the statewide coverage of the services, and the
[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, to the extent
possible the statewide coverage of the services, [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 an approved service
provider makes 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
[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. Section 31.012(a), 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 reasonable copayment for services
provided in accordance with Subchapter D, Chapter 12.
SECTION 4. This Act takes effect September 1, 2013.