Texas 2015 - 84th Regular

Texas Senate Bill SB1980 Compare Versions

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

Old	New	Differences
1	1	84R7918 SCL-D
2	2	By: Garcia S.B. No. 1980
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the participation of an advanced practice nurse as a
8	8	primary care provider for certain governmental and other health
9	9	benefit plans.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Section 533.005, Government Code, is amended by
12	12	adding Subsection (d) to read as follows:
13	13	(d) For purposes of Subsection (a)(13), an advanced
14	14	practice nurse, including an advanced practice nurse certified as a
15	15	psychiatric/mental health advanced practice nurse, may be included
16	16	as a primary care provider in a managed care organization's
17	17	provider network regardless of whether the physician delegating to
18	18	or supervising the advanced practice nurse under Subchapter B,
19	19	Chapter 157, Occupations Code, is in the provider network. If a
20	20	managed care organization includes an advanced practice nurse as a
21	21	primary care provider under this subsection, the physician
22	22	delegating to or supervising the advanced practice nurse is part of
23	23	the network for purposes of supervision. This subsection may not be
24	24	construed as authorizing a managed care organization to supervise
25	25	or control the practice of medicine as prohibited by Subtitle B,
26	26	Title 3, Occupations Code.
27	27	SECTION 2. Section 62.1551, Health and Safety Code, is
28	28	amended to read as follows:
29	29	Sec. 62.1551. INCLUSION OF CERTAIN HEALTH CARE PROVIDERS IN
30	30	PROVIDER NETWORKS. (a) Notwithstanding any other law, including
31	31	Sections 843.312 and 1301.052, Insurance Code, the executive
32	32	commissioner of the commission shall adopt rules to require a
33	33	managed care organization or other entity to ensure that advanced
34	34	practice registered nurses and physician assistants are available
35	35	as primary care providers in the organization's or entity's
36	36	provider network. The rules must require advanced practice
37	37	registered nurses and physician assistants to be treated in the
38	38	same manner as primary care physicians with regard to:
39	39	(1) selection and assignment as primary care
40	40	providers;
41	41	(2) inclusion as primary care providers in the
42	42	provider network; and
43	43	(3) inclusion as primary care providers in any
44	44	provider network directory maintained by the organization or
45	45	entity.
46	46	(b) For purposes of Subsection (a), an advanced practice
47	47	nurse, including an advanced practice nurse certified as a
48	48	psychiatric/mental health advanced practice nurse, may be included
49	49	as a primary care provider in a managed care organization's or
50	50	entity's provider network regardless of whether the physician
51	51	delegating to or supervising the advanced practice nurse under
52	52	Subchapter B, Chapter 157, Occupations Code, is in the provider
53	53	network. If a managed care organization or other entity includes an
54	54	advanced practice nurse as a primary care provider under this
55	55	subsection, the physician delegating to or supervising the advanced
56	56	practice nurse is part of the provider network for purposes of
57	57	supervision.
58	58	(c) This section may not be construed as authorizing a
59	59	managed care organization or other entity to supervise or control
60	60	the practice of medicine as prohibited by Subtitle B, Title 3,
61	61	Occupations Code.
62	62	SECTION 3. Section 32.024(gg), Human Resources Code, is
63	63	amended to read as follows:
64	64	(gg) Notwithstanding any other law, including Sections
65	65	843.312 and 1301.052, Insurance Code, the department shall ensure
66	66	that advanced practice registered nurses, including advanced
67	67	practice registered nurses certified as psychiatric/mental health
68	68	advanced practice nurses, and physician assistants may be selected
69	69	by and assigned to recipients of medical assistance as the primary
70	70	care providers of those recipients regardless of whether the
71	71	physician delegating to or supervising the advanced practice
72	72	registered nurse under Subchapter B, Chapter 157, Occupations Code,
73	73	is included in any directory of providers of medical assistance
74	74	maintained by the department. If an advanced practice registered
75	75	nurse is included as a primary care provider under this subsection,
76	76	the physician delegating to or supervising the advanced practice
77	77	registered nurse is included in the directory for purposes of
78	78	supervision. This subsection may not be construed as authorizing
79	79	the department to supervise or control the practice of medicine as
80	80	prohibited by Subtitle B, Title 3, Occupations Code. The
81	81	department must require that advanced practice registered nurses
82	82	and physician assistants be treated in the same manner as primary
83	83	care physicians with regard to:
84	84	(1) selection and assignment as primary care
85	85	providers; and
86	86	(2) inclusion as primary care providers in any
87	87	directory of providers of medical assistance maintained by the
88	88	department.
89	89	SECTION 4. Subchapter I, Chapter 843, Insurance Code, is
90	90	amended by adding Section 843.3125 to read as follows:
91	91	Sec. 843.3125. CONTRACTS WITH ADVANCED PRACTICE NURSES.
92	92	(a) A health maintenance organization may contract directly with
93	93	an advanced practice nurse to provide health care services on
94	94	behalf of the health maintenance organization regardless of whether
95	95	the physician delegating to or supervising the advanced practice
96	96	nurse under Subchapter B, Chapter 157, Occupations Code, provides
97	97	health care services for the health maintenance organization.
98	98	(b) If a health maintenance organization contracts directly
99	99	with an advanced practice nurse under Subsection (a), the physician
100	100	delegating to or supervising the advanced practice nurse is part of
101	101	an applicable limited provider network for purposes of supervision.
102	102	(c) This section may not be construed as authorizing a
103	103	health maintenance organization to supervise or control the
104	104	practice of medicine as prohibited by Subtitle B, Title 3,
105	105	Occupations Code.
106	106	SECTION 5. Subchapter B, Chapter 1301, Insurance Code, is
107	107	amended by adding Section 1301.0525 to read as follows:
108	108	Sec. 1301.0525. DESIGNATION OF ADVANCED PRACTICE NURSES AS
109	109	PREFERRED PROVIDERS. (a) An insurer offering a preferred provider
110	110	benefit plan may designate an advanced practice nurse as a
111	111	preferred provider regardless of whether the physician delegating
112	112	to or supervising the advanced practice nurse under Subchapter B,
113	113	Chapter 157, Occupations Code, is a preferred provider.
114	114	(b) If an insurer designates an advanced practice nurse as a
115	115	preferred provider under Subsection (a), the physician delegating
116	116	to or supervising the advanced practice nurse is a preferred
117	117	provider for purposes of supervision.
118	118	(c) This section may not be construed as authorizing an
119	119	insurer to supervise or control the practice of medicine as
120	120	prohibited by Subtitle B, Title 3, Occupations Code.
121	121	SECTION 6. If before implementing any provision of this Act
122	122	a state agency determines that a waiver or authorization from a
123	123	federal agency is necessary for implementation of that provision,
124	124	the agency affected by the provision shall request the waiver or
125	125	authorization and may delay implementing that provision until the
126	126	waiver or authorization is granted.
127	127	SECTION 7. This Act takes effect September 1, 2015.