Texas 2019 - 86th Regular

Texas House Bill HB1080 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	86R23218 LED-D
2		-	By: White, Minjarez, Klick, Moody, Coleman, H.B. No. 1080
3		-	et al.
4		-	Substitute the following for H.B. No. 1080:
5		-	By: Frank C.S.H.B. No. 1080
	1	+	86R6449 LED-D
	2	+	By: White H.B. No. 1080
6	3
7	4
8	5		A BILL TO BE ENTITLED
9	6		AN ACT
10		-	relating to the regulation of the practice of physical therapy.
	7	+	relating to prior authorization procedures for physical therapy
	8	+	services in Medicaid and the child health plan program.
11	9		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12		-	SECTION 1. Section 453.301, Occupations Code, is amended to
13		-	read as follows:
14		-	Sec. 453.301. PRACTICE BY PHYSICAL THERAPIST [TREATING
15		-	PATIENT UNDER PRIOR REFERRAL]. (a) A physical therapist may treat
16		-	a patient for an injury or condition in a manner described by
17		-	Section 453.005 without a [that was the subject of a prior] referral
18		-	if the physical therapist:
19		-	(1) has been licensed to practice physical therapy for
20		-	at least one year;
21		-	(2) is covered by professional liability insurance in
22		-	the minimum amount required by board rule [notifies the referring
23		-	practitioner of the therapy not later than the fifth business day
24		-	after the date therapy is begun]; and
25		-	(3) either:
26		-	(A) possesses a doctoral degree in physical
27		-	therapy from:
28		-	(i) a program that is accredited by the
29		-	Commission on Accreditation in Physical Therapy Education; or
30		-	(ii) an institution that is accredited by
31		-	an agency or association recognized by the United States secretary
32		-	of education; or
33		-	(B) has completed at least 30 hours of continuing
34		-	competence activities in the area of differential diagnosis.
35		-	(a-1) A physical therapist may treat a patient under
36		-	Subsection (a) [begins any episode of treatment before the first
37		-	anniversary of the referral by the referring practitioner;
38		-	[(4) for physical therapy episodes subsequent to the
39		-	episode which was initiated by the referral, treats the patient]
40		-	for not more than [20 treatment sessions or] 30 consecutive
41		-	calendar days[, whichever occurs first ; and
42		-	[(5) satisfies any other requirement set by the
43		-	board].
44		-	(b) The physical therapist must obtain a referral from a
45		-	[confer with the] referring practitioner before the physical
46		-	therapist may continue treatment that exceeds treatment authorized
47		-	under Subsection (a-1) [(a)(4)].
48		-	SECTION 2. Section 453.351(a), Occupations Code, is amended
49		-	to read as follows:
50		-	(a) The board may deny a license or suspend or revoke a
51		-	license, place a license holder on probation, reprimand a license
52		-	holder, impose an administrative penalty, or otherwise discipline a
53		-	license holder if the applicant or license holder has:
54		-	(1) except as provided by Section [453.301 or]
55		-	453.302, provided care [physical therapy] to a person outside the
56		-	scope of the physical therapist's practice [without a referral from
57		-	a referring practitioner];
58		-	(2) used drugs or intoxicating liquors to an extent
59		-	that affects the license holder's or applicant's professional
60		-	competence;
61		-	(3) been convicted of a felony, including a finding or
62		-	verdict of guilty, an admission of guilt, or a plea of nolo
63		-	contendere, in this state or in any other state or nation;
64		-	(4) obtained or attempted to obtain a license by fraud
65		-	or deception;
66		-	(5) been grossly negligent in the practice of physical
67		-	therapy or in acting as a physical therapist assistant;
68		-	(6) been found to be mentally incompetent by a court;
69		-	(7) practiced physical therapy in a manner detrimental
70		-	to the public health and welfare;
71		-	(8) had a license to practice physical therapy revoked
72		-	or suspended or had other disciplinary action taken against the
73		-	license holder or applicant;
74		-	(9) had the license holder's or applicant's
75		-	application for a license refused, revoked, or suspended by the
76		-	proper licensing authority of another state or nation; or
77		-	(10) in the case of a physical therapist assistant,
78		-	treated a person other than under the direction of a physical
79		-	therapist.
80		-	SECTION 3. Not later than November 1, 2019, the Texas Board
81		-	of Physical Therapy Examiners shall adopt rules necessary to
82		-	implement Section 453.301, Occupations Code, as amended by this
83		-	Act.
84		-	SECTION 4. This Act takes effect September 1, 2019.
	10	+	SECTION 1. Subchapter B, Chapter 531, Government Code, is
	11	+	amended by adding Section 531.0755 to read as follows:
	12	+	Sec. 531.0755. PRIOR AUTHORIZATION PROCEDURES FOR PHYSICAL
	13	+	THERAPY SERVICES. (a) The commission shall standardize prior
	14	+	authorization request procedures for physical therapy services in
	15	+	Medicaid and the child health plan program by:
	16	+	(1) developing a standard prior authorization request
	17	+	form for use in both fee-for-service and managed care delivery
	18	+	models;
	19	+	(2) requiring a provider to submit a prior
	20	+	authorization request to the entity serving as the state's Medicaid
	21	+	claims administrator using the standard prior authorization
	22	+	request form;
	23	+	(3) requiring the entity serving as the state's
	24	+	Medicaid claims administrator to make a determination regarding the
	25	+	prior authorization; and
	26	+	(4) if applicable, requiring the entity serving as the
	27	+	state's Medicaid claims administrator to forward for processing the
	28	+	prior authorization request and the determination to the managed
	29	+	care organization with which the Medicaid recipient or child health
	30	+	plan program enrollee is enrolled.
	31	+	(b) A managed care organization with which a Medicaid
	32	+	recipient or child health plan program enrollee is enrolled may not
	33	+	require a provider or the recipient or enrollee to use any prior
	34	+	authorization request procedure for physical therapy services
	35	+	other than the procedure under Subsection (a).
	36	+	SECTION 2. Not later than December 1, 2019, the Health and
	37	+	Human Services Commission shall develop the standard prior
	38	+	authorization request form required by Section 531.0755,
	39	+	Government Code, as added by this Act.
	40	+	SECTION 3. This Act takes effect immediately if it receives
	41	+	a vote of two-thirds of all the members elected to each house, as
	42	+	provided by Section 39, Article III, Texas Constitution. If this
	43	+	Act does not receive the vote necessary for immediate effect, this
	44	+	Act takes effect September 1, 2019.