9 | 3 | | |
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10 | 4 | | |
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11 | 5 | | A BILL TO BE ENTITLED |
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12 | 6 | | AN ACT |
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13 | 7 | | relating to the regulation of certain health organizations |
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14 | 8 | | certified by the Texas Medical Board; providing an administrative |
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15 | 9 | | penalty. |
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16 | 10 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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17 | 11 | | SECTION 1. Section 162.003, Occupations Code, is amended to |
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18 | 12 | | read as follows: |
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19 | 13 | | Sec. 162.003. REFUSAL TO CERTIFY; REVOCATION; PENALTY. On |
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20 | 14 | | a determination that a health organization commits a violation of |
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21 | 15 | | this subtitle or is established, organized, or operated in |
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22 | 16 | | violation of or with the intent to violate this subtitle, the board |
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23 | 17 | | may: |
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24 | 18 | | (1) refuse to certify the health organization on |
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25 | 19 | | application for certification by the organization under Section |
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26 | 20 | | 162.001; |
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27 | 21 | | (2) revoke a certification made under Section 162.001 |
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28 | 22 | | to that organization; or |
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29 | 23 | | (3) impose an administrative penalty against the |
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30 | 24 | | health organization under Subchapter A, Chapter 165. |
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31 | 25 | | SECTION 2. Subchapter A, Chapter 162, Occupations Code, is |
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32 | 26 | | amended by adding Sections 162.004 and 162.005 to read as follows: |
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33 | 27 | | Sec. 162.004. PROCEDURES FOR AND DISPOSITION OF COMPLAINTS |
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34 | 28 | | AGAINST NONPROFIT HEALTH CORPORATIONS. (a) The board shall accept |
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35 | 29 | | and process complaints against a health organization certified |
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36 | 30 | | under Section 162.001(b) for alleged violations of this subchapter |
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37 | 31 | | or any other provision of this subtitle applicable to a health |
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38 | 32 | | organization in the same manner as provided under Subchapter B, |
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39 | 33 | | Chapter 154, and the rules adopted under that subchapter, including |
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40 | 34 | | the requirements to: |
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41 | 35 | | (1) maintain a system to promptly and efficiently act |
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42 | 36 | | on complaints filed with the board; |
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43 | 37 | | (2) ensure that a complaint is not dismissed without |
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44 | 38 | | appropriate consideration; and |
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45 | 39 | | (3) establish methods by which physicians employed by |
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46 | 40 | | a health organization are notified of the name, mailing address, |
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47 | 41 | | and telephone number of the board for the purpose of directing |
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48 | 42 | | complaints under this section to the board. |
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49 | 43 | | (b) Each complaint, adverse report, investigation file, |
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50 | 44 | | other investigation report, and other investigative information in |
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51 | 45 | | the possession of or received or gathered by the board or the |
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52 | 46 | | board's employees or agents relating to a health organization |
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53 | 47 | | certified under Section 162.001(b) is privileged and confidential |
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54 | 48 | | and is not subject to discovery, subpoena, or other means of legal |
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55 | 49 | | compulsion for release to anyone other than the board or the board's |
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56 | 50 | | employees or agents involved in the investigation or discipline of |
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57 | 51 | | a health organization certified under Section 162.001(b). |
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58 | 52 | | (c) The board may dispose of a complaint or resolve the |
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59 | 53 | | investigation of a complaint under this section in a manner |
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60 | 54 | | provided under Subchapter A, Chapter 164, to the extent the board |
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61 | 55 | | determines the provisions of that subchapter can be made applicable |
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62 | 56 | | to a health organization certified under Section 162.001. |
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63 | 57 | | (d) The board may adopt rules as necessary to implement this |
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64 | 58 | | section. |
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65 | 59 | | Sec. 162.005. RETALIATION PROHIBITED. (a) In this |
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66 | 60 | | section, "nonprofit health corporation" means a health |
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67 | 61 | | organization certified under Section 162.001(b). |
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68 | 62 | | (b) A nonprofit health corporation may not, as applicable, |
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69 | 63 | | terminate, demote, retaliate against, discipline, discriminate |
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70 | 64 | | against, or otherwise penalize a person, a person's family member, |
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71 | 65 | | or a person's partner because the person: |
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72 | 66 | | (1) files a complaint under Section 162.004; |
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73 | 67 | | (2) reports in good faith an act or omission that the |
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74 | 68 | | person reasonably believes is a violation or attempted violation of |
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75 | 69 | | applicable state or federal law, including rules adopted under |
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76 | 70 | | state or federal law, to, as appropriate: |
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77 | 71 | | (A) the nonprofit health corporation; |
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78 | 72 | | (B) a regulatory agency; or |
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79 | 73 | | (C) a law enforcement authority; |
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80 | 74 | | (3) initiates or cooperates in an investigation or |
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81 | 75 | | proceeding of a regulatory agency or law enforcement authority |
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82 | 76 | | relating to care or services provided by, or policies of, the |
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83 | 77 | | nonprofit health corporation; or |
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84 | 78 | | (4) communicates to a patient information regarding |
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85 | 79 | | medically appropriate health care. |
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86 | 80 | | (c) A nonprofit health corporation may not prohibit, |
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87 | 81 | | restrict, or discourage a person from taking any action described |
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88 | 82 | | by Subsection (b). |
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89 | 83 | | (d) A person who makes a report under Subsection (b)(2) is |
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90 | 84 | | immune from civil liability for a report made in good faith. |
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91 | 85 | | (e) An employment contract between a nonprofit health |
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92 | 86 | | corporation and a physician must contain a provision requiring the |
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93 | 87 | | nonprofit health corporation to comply with the requirements of |
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94 | 88 | | this section. |
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95 | 89 | | SECTION 3. Section 162.003, Occupations Code, as amended by |
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96 | 90 | | this Act, and Section 162.004, Occupations Code, as added by this |
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97 | 91 | | Act, apply only to a violation by a health organization that occurs |
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98 | 92 | | on or after the effective date of this Act. A violation that occurs |
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99 | 93 | | before the effective date of this Act is governed by the law in |
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100 | 94 | | effect on the date the violation occurred, and the former law is |
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101 | 95 | | continued in effect for that purpose. |
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102 | 96 | | SECTION 4. Section 162.005, Occupations Code, as added by |
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103 | 97 | | this Act, applies only to an adverse action that is taken by a |
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104 | 98 | | nonprofit health corporation on or after the effective date of this |
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105 | 99 | | Act. An adverse action taken before the effective date of this Act |
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106 | 100 | | is governed by the law in effect on the date the adverse action was |
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107 | 101 | | taken, and the former law is continued in effect for that purpose. |
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108 | 102 | | SECTION 5. Section 162.005(e), Occupations Code, as added |
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109 | 103 | | by this Act, applies only to a contract entered into on or after the |
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110 | 104 | | effective date of this Act. |
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111 | 105 | | SECTION 6. This Act takes effect September 1, 2017. |
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