Texas 2015 - 84th Regular

Texas House Bill HB1445 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	84R7767 KEL/AJA-D
2	2	By: Guillen H.B. No. 1445
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to measures to support or enhance graduate medical
8	8	education in this state, including the transfer of assets following
9	9	the dissolution of the Texas Medical Liability Insurance
10	10	Underwriting Association.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Subchapter A, Chapter 58A, Education Code, is
13	13	amended by adding Section 58A.002 to read as follows:
14	14	Sec. 58A.002. PERMANENT FUND SUPPORTING GRADUATE MEDICAL
15	15	EDUCATION. (a) In this section, "trust company" means the Texas
16	16	Treasury Safekeeping Trust Company.
17	17	(b) The permanent fund supporting graduate medical
18	18	education is a special fund in the treasury outside the general
19	19	revenue fund. The fund is composed of:
20	20	(1) money transferred or appropriated to the fund by
21	21	the legislature;
22	22	(2) gifts and grants contributed to the fund; and
23	23	(3) the returns received from investment of money in
24	24	the fund.
25	25	(c) The trust company shall administer the fund. The trust
26	26	company shall determine the amount available for distribution from
27	27	the fund, determined in accordance with a distribution policy that
28	28	is adopted by the comptroller and designed to preserve the
29	29	purchasing power of the fund's assets and to provide a stable and
30	30	predictable stream of annual distributions. Expenses of managing
31	31	the fund's assets shall be paid from the fund. Except as provided
32	32	by this section, money in the fund may not be used for any purpose.
33	33	Sections 403.095 and 404.071, Government Code, do not apply to the
34	34	fund.
35	35	(d) In managing the assets of the fund, through procedures
36	36	and subject to restrictions the trust company considers
37	37	appropriate, the trust company may acquire, exchange, sell,
38	38	supervise, manage, or retain any kind of investment that a prudent
39	39	investor, exercising reasonable care, skill, and caution, would
40	40	acquire or retain in light of the purposes, terms, distribution
41	41	requirements, and other circumstances of the fund then prevailing,
42	42	taking into consideration the investment of all the assets of the
43	43	fund rather than a single investment.
44	44	(e) The amount available for distribution from the fund may
45	45	be appropriated only to fund the programs created under this
46	46	chapter and any other programs designed to support or enhance
47	47	graduate medical education in this state.
48	48	(f) A public or private institution of higher education or
49	49	other entity that may receive money under a program described by
50	50	Subsection (e) may solicit and accept gifts and grants to the fund.
51	51	A gift or grant to the fund must be distributed and appropriated for
52	52	the purposes of the fund, subject to any limitation or requirement
53	53	placed on the gift or grant by the donor or granting entity.
54	54	SECTION 2. Chapter 58A, Education Code, is amended by
55	55	adding Subchapters D, E, and F to read as follows:
56	56	SUBCHAPTER D. CRITICAL SHORTAGE PHYSICIAN GRANT PROGRAM
57	57	Sec. 58A.101. DEFINITIONS. In this subchapter:
58	58	(1) "Center" means the comprehensive health
59	59	professions resource center established under Chapter 105, Health
60	60	and Safety Code.
61	61	(2) "Graduate medical residency training program"
62	62	means a residency or other postgraduate medical training program:
63	63	(A) participation in which may be counted toward
64	64	certification in a medical specialty or subspecialty; and
65	65	(B) that:
66	66	(i) is accredited by the Accreditation
67	67	Council for Graduate Medical Education or the American Osteopathic
68	68	Association; or
69	69	(ii) demonstrates eligibility to apply for
70	70	and receive an accreditation described by Subparagraph (i).
71	71	(3) "Program" means the critical shortage physician
72	72	grant program established under this subchapter.
73	73	(4) "Teaching hospital" means a teaching hospital
74	74	affiliated with a medical school that is described as a medical and
75	75	dental unit under Section 61.003.
76	76	Sec. 58A.102. ESTABLISHMENT OF PROGRAM. The board shall
77	77	establish the critical shortage physician grant program to provide
78	78	grants to teaching hospitals for graduate medical residency
79	79	training programs to increase the number of physicians in the
80	80	medical specialties and subspecialties that are determined by the
81	81	board to be at a critical shortage level in this state.
82	82	Sec. 58A.103. RULES. (a) The board shall adopt rules to
83	83	administer the program, including rules regarding:
84	84	(1) a grant application process;
85	85	(2) reporting requirements for grant recipients; and
86	86	(3) requirements and benchmarks for grant recipients
87	87	to satisfy regarding the granting of additional program funding
88	88	under Section 58A.106.
89	89	(b) The rules adopted under Subsection (a) must require
90	90	grant recipients to submit reports at least quarterly, based on
91	91	outcome measures established by the board in consultation with the
92	92	Legislative Budget Board.
93	93	Sec. 58A.104. ELIGIBILITY. To be eligible to receive a
94	94	grant under this subchapter, a teaching hospital must:
95	95	(1) provide a number of graduate medical residency
96	96	positions in excess of both the cap on the number of positions
97	97	funded by direct graduate medical education payments made under
98	98	Section 1886(h), Social Security Act (42 U.S.C. Section 1395ww(h)),
99	99	and the cap on the number of positions funded by indirect medical
100	100	education payments made under Section 1886(d)(5)(B), Social
101	101	Security Act (42 U.S.C. Section 1395ww(d)(5)(B)); and
102	102	(2) offer or seek to offer one or more graduate medical
103	103	residency training programs in a specialty described by Section
104	104	58.008(a) or in any other medical specialty or subspecialty
105	105	determined by the board to be at a critical shortage level in this
106	106	state.
107	107	Sec. 58A.105. USE OF FUNDS. In each state fiscal year, the
108	108	board shall award grants for establishing new accredited graduate
109	109	medical residency training programs or increasing the number of
110	110	residency positions in existing accredited graduate medical
111	111	residency training programs in specialties described by Section
112	112	58.008(a) or in any other medical specialties or subspecialties
113	113	determined by the board to be at a critical shortage level in this
114	114	state.
115	115	Sec. 58A.106. ADDITIONAL USE: START-UP COSTS. (a) If in a
116	116	state fiscal year excess program funds remain after funds are
117	117	granted under Section 58A.105, the board may grant additional
118	118	program funding to teaching hospitals to pay any start-up costs
119	119	associated with establishing and seeking accreditation for a new
120	120	graduate medical residency training program in a specialty
121	121	described by Section 58.008(a) or in any other medical specialty or
122	122	subspecialty determined by the board to be at a critical shortage
123	123	level in this state, provided that no other federal or state funding
124	124	is available for that program.
125	125	(b) To be eligible for funding under this section, start-up
126	126	costs must be directly related to the establishment or
127	127	accreditation of the new program.
128	128	(c) The board may grant program funding under this section
129	129	to pay a percentage of the total amount of applicable start-up costs
130	130	for the teaching hospital, not to exceed 20 percent.
131	131	Sec. 58A.107. REDUCTION IN FUNDING. The board shall limit
132	132	or withhold funding from grant recipients that do not comply with
133	133	reporting requirements or that use grant funds for a purpose not
134	134	authorized by this subchapter. The board shall seek reimbursement
135	135	with respect to any grant funds that are not used for purposes
136	136	authorized by this subchapter.
137	137	Sec. 58A.108. CRITERIA FOR DETERMINING CRITICAL SHORTAGE
138	138	LEVELS. (a) For purposes of this subchapter, the board shall
139	139	determine critical shortage levels for medical specialties and
140	140	subspecialties in this state according to criteria used by the
141	141	United States Department of Health and Human Services Health
142	142	Resources and Services Administration to designate health
143	143	professional shortage areas.
144	144	(b) In its methodology for determining critical shortage
145	145	levels under this section, the board shall include the results of
146	146	the research conducted by the center under Section 105.009(a)(1),
147	147	Health and Safety Code, and similar research performed by other
148	148	appropriate entities.
149	149	SUBCHAPTER E. TEXAS TEACHING HEALTH CENTER
150	150	GRADUATE MEDICAL EDUCATION GRANT PROGRAM
151	151	Sec. 58A.121. DEFINITIONS. In this subchapter:
152	152	(1) "Graduate medical residency training program"
153	153	means a residency or other postgraduate medical training program:
154	154	(A) participation in which may be counted toward
155	155	certification in a medical specialty or subspecialty; and
156	156	(B) that:
157	157	(i) is accredited by the Accreditation
158	158	Council for Graduate Medical Education or the American Osteopathic
159	159	Association; or
160	160	(ii) demonstrates eligibility to apply for
161	161	and receive an accreditation described by Subparagraph (i).
162	162	(2) "Primary care residency program" means a graduate
163	163	medical residency training program in a specialty described by
164	164	Section 58.008(a).
165	165	(3) "Program" means the Texas teaching health center
166	166	graduate medical education grant program established under this
167	167	subchapter.
168	168	(4) "Teaching health center" means a community-based,
169	169	ambulatory patient care center that operates a primary care
170	170	residency program. The term includes:
171	171	(A) a federally qualified health center, as
172	172	defined by Section 1905(l)(2)(B), Social Security Act (42 U.S.C.
173	173	Section 1396d(l)(2)(B));
174	174	(B) a community mental health center, as defined
175	175	by Section 1861(ff)(3)(B), Social Security Act (42 U.S.C. Section
176	176	1395x(ff)(3)(B));
177	177	(C) a rural health clinic, as defined by Section
178	178	1861(aa)(2), Social Security Act (42 U.S.C. Section 1395x(aa)(2));
179	179	(D) a health center operated by the Indian Health
180	180	Service, an Indian tribe or tribal organization, or an urban Indian
181	181	organization, as defined by Section 4, Indian Health Care
182	182	Improvement Act (25 U.S.C. Section 1603); and
183	183	(E) an entity receiving funds under Title X,
184	184	Public Health Service Act (42 U.S.C. Section 300 et seq.).
185	185	Sec. 58A.122. ESTABLISHMENT OF PROGRAM. The board shall
186	186	establish the Texas teaching health center graduate medical
187	187	education grant program to award grants to teaching health centers
188	188	for the purpose of establishing new primary care residency programs
189	189	or increasing the number of residency positions in existing primary
190	190	care residency programs.
191	191	Sec. 58A.123. RULES. (a) The board shall adopt rules to
192	192	administer the program, including rules regarding:
193	193	(1) a grant application process;
194	194	(2) reporting requirements for grant recipients under
195	195	Section 58A.128; and
196	196	(3) the amount of the payments for direct expenses and
197	197	indirect expenses, as defined by and calculated in the same manner
198	198	as those expenses are calculated under the federal rules described
199	199	by Subsection (b).
200	200	(b) The rules adopted under this subchapter must be based as
201	201	nearly as possible on the rules adopted under the federal teaching
202	202	health centers development grant program established under Section
203	203	5508, Patient Protection and Affordable Care Act of 2010 (Pub. L.
204	204	No. 111-148).
205	205	(c) The rules adopted in relation to the reporting
206	206	requirements under Section 58A.128 must also:
207	207	(1) authorize the board to conduct audits of grant
208	208	recipients to the extent necessary to ensure the accuracy and
209	209	completeness of their annual reports; and
210	210	(2) specify a mandatory amount of reduction in grant
211	211	funds under Section 58A.127 for a failure to submit an accurate or
212	212	complete report.
213	213	Sec. 58A.124. AMOUNT AND DURATION OF GRANT. Subject to
214	214	Section 58A.127, the board may award grants under this subchapter
215	215	for a term of not more than three years, and the maximum award to a
216	216	recipient may not exceed $500,000 during each state fiscal year.
217	217	Sec. 58A.125. RELATIONSHIP OF GRANTS TO OTHER FEDERAL
218	218	PAYMENTS FOR GRADUATE MEDICAL EDUCATION. A grant awarded by the
219	219	board under this subchapter is in addition to any payments for:
220	220	(1) direct graduate medical education costs under
221	221	Section 1886(h), Social Security Act (42 U.S.C. Section 1395ww(h));
222	222	(2) indirect medical education costs under Section
223	223	1886(d)(5)(B), Social Security Act (42 U.S.C. Section
224	224	1395ww(d)(5)(B)); and
225	225	(3) direct costs of medical education under Section
226	226	1886(k), Social Security Act (42 U.S.C. Section 1395ww(k)).
227	227	Sec. 58A.126. USE OF FUNDS. A grant awarded under this
228	228	subchapter may be used only to cover the costs of establishing a new
229	229	primary care residency program at a teaching health center or the
230	230	costs of increasing the number of residency positions in an
231	231	existing primary care residency program, including costs
232	232	associated with:
233	233	(1) curriculum development;
234	234	(2) recruitment, training, and retention of residents
235	235	and faculty;
236	236	(3) obtaining accreditation by the Accreditation
237	237	Council for Graduate Medical Education or the American Osteopathic
238	238	Association; and
239	239	(4) faculty salaries during the development phase.
240	240	Sec. 58A.127. REDUCTION IN FUNDING. The board shall limit
241	241	or withhold funding from grant recipients that do not comply with
242	242	reporting requirements or that use grant funds for a purpose not
243	243	authorized by this subchapter. The board shall seek reimbursement
244	244	with respect to any grant funds that are not used for purposes
245	245	authorized by this subchapter.
246	246	Sec. 58A.128. REPORTING. (a) A grant recipient shall
247	247	submit an annual report that fully accounts for the use of a grant
248	248	awarded under this subchapter.
249	249	(b) The annual report must be made in the form and manner
250	250	specified by the board and must include the following information
251	251	for the most recent residency academic year completed immediately
252	252	before the applicable state fiscal year:
253	253	(1) the types of primary care residency programs that
254	254	the grant recipient provided for residents;
255	255	(2) the number of approved training positions in those
256	256	programs for part-time or full-time residents;
257	257	(3) the number of part-time or full-time residents
258	258	who:
259	259	(A) completed their residency training in those
260	260	programs at the end of the residency academic year; and
261	261	(B) care for vulnerable populations living in
262	262	underserved areas; and
263	263	(4) any other information considered appropriate by
264	264	the board.
265	265	SUBCHAPTER F. GRADUATE MEDICAL EDUCATION
266	266	PARTNERSHIP GRANT PROGRAM
267	267	Sec. 58A.151. DEFINITIONS. In this subchapter:
268	268	(1) "Graduate medical education partnership" means a
269	269	partnership entered into by a teaching health center and an
270	270	accredited graduate medical residency training program offered by a
271	271	hospital or medical school.
272	272	(2) "Graduate medical residency training program"
273	273	means a residency or other postgraduate medical training program:
274	274	(A) participation in which may be counted toward
275	275	certification in a medical specialty or subspecialty; and
276	276	(B) that:
277	277	(i) is accredited by the Accreditation
278	278	Council for Graduate Medical Education or the American Osteopathic
279	279	Association; or
280	280	(ii) demonstrates eligibility to apply for
281	281	and receive an accreditation described by Subparagraph (i).
282	282	(3) "Primary care residency program" means a graduate
283	283	medical residency training program in a specialty described by
284	284	Section 58.008(a).
285	285	(4) "Program" means the graduate medical education
286	286	partnership grant program established under this subchapter.
287	287	(5) "Teaching health center" means a community-based,
288	288	ambulatory patient care center that operates a primary care
289	289	residency program. The term includes:
290	290	(A) a federally qualified health center, as
291	291	defined by Section 1905(l)(2)(B), Social Security Act (42 U.S.C.
292	292	Section 1396d(l)(2)(B));
293	293	(B) a community mental health center, as defined
294	294	by Section 1861(ff)(3)(B), Social Security Act (42 U.S.C. Section
295	295	1395x(ff)(3)(B));
296	296	(C) a rural health clinic, as defined by Section
297	297	1861(aa)(2), Social Security Act (42 U.S.C. Section 1395x(aa)(2));
298	298	(D) a health center operated by the Indian Health
299	299	Service, an Indian tribe or tribal organization, or an urban Indian
300	300	organization, as defined by Section 4, Indian Health Care
301	301	Improvement Act (25 U.S.C. Section 1603); and
302	302	(E) an entity receiving funds under Title X,
303	303	Public Health Service Act (42 U.S.C. Section 300 et seq.).
304	304	Sec. 58A.152. ESTABLISHMENT OF PROGRAM. The board shall
305	305	establish the graduate medical education partnership grant program
306	306	to allow a teaching health center that is establishing and seeking
307	307	accreditation for a new primary care residency program to partner
308	308	with an accredited graduate medical residency training program
309	309	offered by a hospital or medical school.
310	310	Sec. 58A.153. RULES. The board shall adopt rules to
311	311	administer the program, including rules regarding a grant
312	312	application process and reporting requirements for grant
313	313	recipients.
314	314	Sec. 58A.154. USE OF FUNDS. The board shall award grants to
315	315	each participant in a graduate medical education partnership to:
316	316	(1) facilitate a mentoring relationship between
317	317	partners that will provide information and guidance for the
318	318	participating teaching health center during the accreditation
319	319	process; and
320	320	(2) assist the partners in building a collaborative
321	321	working relationship for the future.
322	322	Sec. 58A.155. REDUCTION IN FUNDING. The board shall limit
323	323	or withhold funding from grant recipients that do not comply with
324	324	reporting requirements or that use grant funds for a purpose not
325	325	authorized by this subchapter. The board shall seek reimbursement
326	326	for any grant funds that are not used for purposes authorized by
327	327	this subchapter.
328	328	SECTION 3. Chapter 105, Health and Safety Code, is amended
329	329	by adding Section 105.009 to read as follows:
330	330	Sec. 105.009. RESEARCH REGARDING GRADUATE MEDICAL
331	331	EDUCATION SYSTEM. (a) The comprehensive health professions
332	332	resource center shall conduct research:
333	333	(1) to identify:
334	334	(A) the ratio of primary care to non-primary care
335	335	physicians that is necessary and appropriate to meet the current
336	336	and future health care needs of this state; and
337	337	(B) all medical specialties and subspecialties
338	338	that are at critical shortage levels in this state, together with
339	339	the geographic location of the physicians in those specialties and
340	340	subspecialties; and
341	341	(2) regarding the overall supply of physicians in this
342	342	state and any other issues that are relevant to the status of the
343	343	state's graduate medical education system and the ability of that
344	344	system to meet the current and future health care needs of this
345	345	state.
346	346	(b) Not later than August 31 of each even-numbered year, the
347	347	council shall report the results of the center's research to the
348	348	Legislative Budget Board, the Texas Higher Education Coordinating
349	349	Board, the office of the governor, and the standing committees of
350	350	each house of the legislature with primary jurisdiction over state
351	351	finance or appropriations.
352	352	SECTION 4. Chapter 2203, Insurance Code, is amended by
353	353	adding Subchapter J to read as follows:
354	354	SUBCHAPTER J. DISSOLUTION OF ASSOCIATION; REACTIVATION OF
355	355	ASSOCIATION BY COMMISSIONER
356	356	Sec. 2203.451. DISSOLUTION DATE. The association shall
357	357	cease all operations before and is dissolved on August 31, 2017.
358	358	Sec. 2203.452. DISSOLUTION PLAN. (a) The board of
359	359	directors, in consultation with the department, shall develop a
360	360	dissolution plan to:
361	361	(1) wind down and cease the association's operations
362	362	before the dissolution date established by this subchapter; and
363	363	(2) transfer to the commissioner and the department:
364	364	(A) any obligations of the association that
365	365	survive the association's dissolution;
366	366	(B) any rights of the association that:
367	367	(i) accrued before the association's
368	368	dissolution and survive the association's dissolution; or
369	369	(ii) accrue after the association's
370	370	dissolution with respect to coverage issued by the association
371	371	before the association's dissolution;
372	372	(C) any authority previously held by the
373	373	association the continuation of which is necessary or appropriate;
374	374	and
375	375	(D) subject to Section 2203.456, any association
376	376	assets.
377	377	(b) The dissolution plan may provide that the obligations,
378	378	rights, authority, and, subject to Section 2203.456, assets
379	379	transferred to the commissioner and department may be transferred
380	380	to a liquidator appointed by the commissioner.
381	381	(c) The dissolution plan must be adopted by the commissioner
382	382	by rule.
383	383	Sec. 2203.453. ISSUANCE AND RENEWAL OF INSURANCE COVERAGE;
384	384	TERMINATION OF POLICIES. The association may not issue or renew
385	385	an insurance policy on or after the effective date of this
386	386	subchapter. A policy issued or renewed by the association before
387	387	that date shall continue in force until terminated in accordance
388	388	with the terms and conditions of the policy.
389	389	Sec. 2203.454. ACCEPTANCE AND DISPOSITION OF CLAIMS. (a)
390	390	The association may continue to accept claims under association
391	391	policies until:
392	392	(1) the dissolution date established by this
393	393	subchapter; or
394	394	(2) an earlier claims acceptance deadline established
395	395	in the dissolution plan.
396	396	(b) The dissolution plan must establish processes to ensure
397	397	that, to the maximum extent reasonably possible, claims made under
398	398	association policies before the dissolution date established by
399	399	this subchapter are processed and paid or otherwise appropriately
400	400	disposed of before the dissolution date established by this
401	401	subchapter.
402	402	(c) The dissolution plan must provide that the department or
403	403	a liquidator appointed in accordance with the dissolution plan
404	404	will:
405	405	(1) take over the processing and disposition of any
406	406	claims under association policies accepted by the association that
407	407	are outstanding on the dissolution date established by this
408	408	subchapter; and
409	409	(2) accept, process, and dispose of any claims under
410	410	association policies that are made after the latest date on which
411	411	the association accepts claims under Subsection (a).
412	412	Sec. 2203.455. POST-DISSOLUTION CLAIMS. (a) The
413	413	dissolution plan must provide for a reasonable and actuarially
414	414	sound arrangement, through retention of reserves, purchase of
415	415	reinsurance, or otherwise, to ensure that sufficient resources
416	416	remain available to pay liability of the association that may arise
417	417	in connection with claims made under association policies on or
418	418	after the dissolution date established by this subchapter.
419	419	(b) If the arrangement provided under Subsection (a) proves
420	420	inadequate, the claims that cannot be satisfied shall be treated as
421	421	claims against an insolvent insurer liquidated under Chapter 443.
422	422	Sec. 2203.456. TRANSFER OF ASSETS. (a) Not later than
423	423	October 1, 2017, association assets not retained by the department
424	424	under Subsection (b) or otherwise transferred or applied in
425	425	accordance with this section shall be transferred to the permanent
426	426	fund supporting graduate medical education established under
427	427	Section 58A.002, Education Code.
428	428	(b) The department shall retain assets sufficient to pay
429	429	claims under association policies that are outstanding on the asset
430	430	transfer date established by Subsection (a). The department shall
431	431	retain, transfer, or apply association assets as necessary for the
432	432	portion of the dissolution plan required by Section 2203.455(a).
433	433	(c) If a liquidator is appointed under the dissolution plan,
434	434	the department may transfer assets to the liquidator in accordance
435	435	with the dissolution plan.
436	436	(d) Assets of the policyholder's stabilization reserve fund
437	437	for nursing homes and assisted living facilities established under
438	438	Section 2203.303 shall be transferred to the general revenue fund
439	439	to be appropriated as provided by Section 2203.303(e).
440	440	Sec. 2203.457. ANNUAL REPORT. The department shall, as
441	441	part of each annual report made under Section 32.021 after the asset
442	442	transfer date established by Section 2203.456(a):
443	443	(1) account for assets retained under Section
444	444	2203.456(b) or transferred under Section 2203.456(c) or (d); and
445	445	(2) report on the receipt, processing, and disposition
446	446	of claims under association policies.
447	447	Sec. 2203.458. REACTIVATION OF ASSOCIATION. (a) After the
448	448	dissolution of the association and the transfer of the
449	449	association's assets in accordance with this subchapter, the
450	450	commissioner may, after notice and hearing, order the reactivation
451	451	of the association and authorize the association to resume
452	452	operations in accordance with the provisions of this chapter other
453	453	than this subchapter.
454	454	(b) A hearing to determine the need to reactivate the
455	455	association shall be held:
456	456	(1) on petition of:
457	457	(A) the Texas Medical Association;
458	458	(B) the Texas Podiatric Medical Association;
459	459	(C) the Texas Hospital Association; or
460	460	(D) at least 15 physicians or health care
461	461	providers practicing or operating in this state; or
462	462	(2) on a finding by the commissioner that physicians
463	463	or health care providers, or any category of physicians or health
464	464	care providers, in this state are threatened with the possibility
465	465	of being unable to secure medical liability insurance.
466	466	(c) Not later than the 15th day before the date set for a
467	467	hearing under this section, notice of the hearing shall be given to
468	468	each insurer that would be a member of the association under Section
469	469	2203.055 if the association were reactivated.
470	470	(d) If the commissioner finds the reactivation of the
471	471	association is in the public interest, the commissioner shall order
472	472	the reactivation of the association. In making a determination
473	473	under this section, the commissioner shall consider the potential
474	474	impact on and harm or benefit to consumers of health care,
475	475	physicians and health care providers, and the overall availability
476	476	of medical liability insurance in this state. The order must:
477	477	(1) designate the category or categories of physicians
478	478	or health care providers who are eligible to secure medical
479	479	liability insurance coverage from the association; and
480	480	(2) specify a date that is not fewer than 15 or more
481	481	than 60 days after the date of the order on which the provisions of
482	482	this chapter other than this subchapter become effective.
483	483	(e) If an order of reactivation is made under this section,
484	484	the provisions of this chapter other than this subchapter shall
485	485	take effect as if they had been enacted into law with the effective
486	486	date specified in the commissioner's order.
487	487	(f) The commissioner's order shall specify a deadline for
488	488	the initial election and appointment of members of the board of
489	489	directors under Section 2203.052. Notwithstanding Section
490	490	2203.052, the initial term for each director elected or appointed
491	491	under this section expires on the first October 1 that follows the
492	492	election and appointment deadline specified in the order.
493	493	Sec. 2203.459. DISSOLUTION AFTER REACTIVATION. (a) After
494	494	reactivation of the association under Section 2203.458, the
495	495	commissioner may, after notice and hearing, order the dissolution
496	496	of the association. Dissolution of the association under this
497	497	section shall be done in accordance with the provisions of this
498	498	subchapter that governed the dissolution of the association on the
499	499	dissolution date established by Section 2203.451.
500	500	(b) A hearing to determine whether to dissolve the
501	501	association under this section shall be held only at the
502	502	commissioner's discretion.
503	503	(c) The commissioner shall issue an order to dissolve the
504	504	association under this section if the commissioner finds that:
505	505	(1) there is no category of physicians or health care
506	506	providers in this state threatened with the possibility of being
507	507	unable to secure medical liability insurance; and
508	508	(2) dissolution of the association is in the public
509	509	interest.
510	510	(d) In making a determination under Subsection (c)(2), the
511	511	commissioner shall consider the potential impact on and harm or
512	512	benefit to consumers of health care, physicians and health care
513	513	providers, and the overall availability of medical liability
514	514	insurance in this state.
515	515	(e) The commissioner's order must:
516	516	(1) prescribe:
517	517	(A) a dissolution date;
518	518	(B) a date on and after which the association may
519	519	not issue or renew insurance policies; and
520	520	(C) an asset transfer date; and
521	521	(2) direct the board of directors to develop a
522	522	dissolution plan in accordance with this subchapter.
523	523	(f) A dissolution plan developed under this section must be
524	524	adopted by the commissioner by rule.
525	525	(g) On the asset transfer date prescribed by the
526	526	commissioner's order, association assets not retained by the
527	527	department or otherwise transferred or applied in accordance with
528	528	Section 2203.456(b) or (c) shall be transferred to the general
529	529	revenue fund. After that date, the department shall report on
530	530	assets and claims as prescribed by Section 2203.457.
531	531	SECTION 5. Sections 2203.303(d) and (e), Insurance Code,
532	532	are amended to read as follows:
533	533	(d) The [Notwithstanding Sections 11, 12, and 13, Article
534	534	21.49-3, the] policyholder's stabilization reserve fund under this
535	535	section may be terminated only by law.
536	536	(e) On [Notwithstanding Section 11, Article 21.49-3, on]
537	537	termination of the policyholder's stabilization reserve fund under
538	538	this section, all assets of the fund shall be transferred to the
539	539	general revenue fund to be appropriated for purposes related to
540	540	ensuring the provision of the kinds of liability insurance coverage
541	541	that the association may provide under this chapter to nursing
542	542	homes and assisted living facilities.
543	543	SECTION 6. Articles 21.49-3 and 21.49-3a, Insurance Code,
544	544	are repealed.
545	545	SECTION 7. (a) Not later than December 31, 2015, the Texas
546	546	Higher Education Coordinating Board shall adopt rules for the
547	547	critical shortage physician grant program, the Texas teaching
548	548	health center graduate medical education grant program, and the
549	549	graduate medical education partnership grant program established
550	550	under Subchapters D, E, and F, Chapter 58A, Education Code,
551	551	respectively, as added by this Act.
552	552	(b) The board shall award grants under the programs
553	553	described by Subsection (a) of this section beginning with the
554	554	2016-2017 state fiscal year.
555	555	SECTION 8. This Act takes effect immediately if it receives
556	556	a vote of two-thirds of all the members elected to each house, as
557	557	provided by Section 39, Article III, Texas Constitution. If this
558	558	Act does not receive the vote necessary for immediate effect, this
559	559	Act takes effect September 1, 2015.