85R10251 BEE-D
By: Zedler H.B. No. 3310
A BILL TO BE ENTITLED
AN ACT
relating to prohibiting certain discrimination against a physician
or an applicant for a license to practice medicine in this state.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 241.003, Health and Safety Code, is
amended by adding Subdivisions (7-a) and (16) to read as follows:
(7-a) "Maintenance of certification" has the meaning
assigned by Section 151.002, Occupations Code.
(16) "Specialty medical board certification" has the
meaning assigned by Section 151.002, Occupations Code.
SECTION 2. Subchapter A, Chapter 241, Health and Safety
Code, is amended by adding Section 241.011 to read as follows:
Sec. 241.011. DISCRIMINATION AGAINST PHYSICIAN BASED ON
SPECIALTY MEDICAL BOARD CERTIFICATION OR MAINTENANCE OF
CERTIFICATION. Notwithstanding any other law, the owner, operator,
or governing body of a hospital that is licensed in this state may
not:
(1) require a physician to obtain or maintain any form
of specialty medical board certification or maintenance of
certification to be eligible for medical staff membership or
professional privileges, including admitting privileges; or
(2) discriminate against, disfavor, or disadvantage a
physician who does not obtain or maintain specialty medical board
certification or maintenance of certification.
SECTION 3. Subtitle F, Title 8, Insurance Code, is amended
by adding Chapter 1461 to read as follows:
CHAPTER 1461. DISCRIMINATION AGAINST PHYSICIAN BASED ON MEDICAL
SPECIALTY BOARD CERTIFICATION OR MAINTENANCE OF CERTIFICATION
Sec. 1461.001. DEFINITIONS. In this chapter:
(1) "Enrollee" means an individual who is eligible to
receive health care services under a managed care plan.
(2) "Maintenance of certification" has the meaning
assigned by Section 151.002, Occupations Code.
(3) "Managed care plan" means a health benefit plan
under which medical care services are provided to enrollees through
contracts with physicians and that requires enrollees to use
participating physicians or that provides a different level of
coverage for enrollees who use participating physicians. The term
includes a health benefit plan issued by:
(A) a health maintenance organization;
(B) a preferred provider benefit plan issuer; or
(C) any other entity that issues a health benefit
plan, including an insurance company.
(4) "Participating physician" means a physician who
has directly or indirectly contracted with a health benefit plan
issuer to provide services to enrollees.
(5) "Physician" means a person licensed to practice
medicine in this state.
(6) "Specialty medical board certification" has the
meaning assigned by Section 151.002, Occupations Code.
Sec. 1461.002. APPLICABILITY. (a) This chapter applies to
a physician regardless of whether the physician is a participating
physician.
(b) This chapter applies to a person with whom a managed
care plan issuer contracts to:
(1) process or pay claims;
(2) obtain the services of physicians to provide
medical care services to enrollees; or
(3) issue verifications or preauthorizations.
Sec. 1461.003. DISCRIMINATION AGAINST PHYSICIAN BASED ON
SPECIALTY MEDICAL BOARD CERTIFICATION, MAINTENANCE OF
CERTIFICATION, OR STAFF PRIVILEGES. Notwithstanding any other law,
a managed care plan issuer may not:
(1) require for the payment or reimbursement of a
claim under the plan that a physician:
(A) obtain or maintain any form of specialty
medical board certification or maintenance of certification; or
(B) maintain hospital medical staff privileges;
or
(2) discriminate against, disfavor, or disadvantage a
physician who does not obtain or maintain specialty medical board
certification or maintenance of certification.
SECTION 4. Section 151.002(a), Occupations Code, is amended
by adding Subdivisions (6-b) and (13-a) to read as follows:
(6-b) "Maintenance of certification" means a process
of successful completion of periodic recertification examinations
that are required to maintain specialty medical board
certification.
(13-a) "Specialty medical board certification" means
certification by a board that specializes in one particular area of
medicine and typically requires additional and more strenuous
examinations than state licensing boards require to practice
medicine.
SECTION 5. Chapter 151, Occupations Code, is amended by
adding Subchapter C to read as follows:
SUBCHAPTER C. DISCRIMINATION AGAINST PHYSICIAN BASED ON MEDICAL
SPECIALTY BOARD CERTIFICATION OR MAINTENANCE OF CERTIFICATION
Sec. 151.101. DISCRIMINATION REGARDING PRACTICE OF
MEDICINE PROHIBITED. Notwithstanding any other law, the board may
not:
(1) require any form of specialty medical board
certification or maintenance of certification to practice medicine
in this state; or
(2) require any form of specialty medical board
certification or maintenance of certification for a person to be
eligible under this subtitle for:
(A) a license; or
(B) an initial or renewal registration permit.
Sec. 151.102. DISCRIMINATION BY STATE AGENCY PROHIBITED.
Notwithstanding any other law the board or another state agency may
not discriminate against, disfavor, or disadvantage a physician who
does not obtain or maintain specialty medical board certification
or maintenance of certification.
Sec. 151.103. DISCRIMINATION IN COMPACT PROHIBITED.
Notwithstanding any other law the board or another state agency may
not enter into a compact, including an interstate compact, that
discriminates against, disfavors, or disadvantages a physician who
does not obtain or maintain specialty medical board certification
or maintenance of certification.
SECTION 6. This Act takes effect September 1, 2017.