Texas 2023 - 88th Regular

Texas House Bill HB1686 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New	Differences
1	1	88R4402 EAS-F
2	2	By: Oliverson H.B. No. 1686
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to prohibitions on the provision to certain children of
8	8	procedures and treatments for gender transitioning, gender
9	9	reassignment, or gender dysphoria and on the use of public money or
10	10	public assistance to provide those procedures and treatments.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Section 62.151, Health and Safety Code, is
13	13	amended by adding Subsection (g) to read as follows:
14	14	(g) The child health plan may not provide coverage for
15	15	services prohibited by Section 161.702 that are intended to
16	16	transition a child's biological sex as determined by the child's sex
17	17	organs, chromosomes, and endogenous profiles.
18	18	SECTION 2. Chapter 161, Health and Safety Code, is amended
19	19	by adding Subchapter X to read as follows:
20	20	SUBCHAPTER X. GENDER TRANSITIONING AND GENDER REASSIGNMENT
21	21	PROCEDURES AND TREATMENTS FOR CERTAIN CHILDREN
22	22	Sec. 161.701. DEFINITIONS. In this subchapter:
23	23	(1) "Child" means an individual who is younger than 18
24	24	years of age.
25	25	(2) "Health care provider" means a person other than a
26	26	physician who is licensed, certified, or otherwise authorized by
27	27	this state's laws to provide or render health care or to dispense or
28	28	prescribe a prescription drug in the ordinary course of business or
29	29	practice of a profession.
30	30	(3) "Medicaid" means the medical assistance program
31	31	established under Chapter 32, Human Resources Code.
32	32	(4) "Physician" means a person licensed to practice
33	33	medicine in this state.
34	34	Sec. 161.702. PROHIBITED PROVISION OF GENDER TRANSITIONING
35	35	OR GENDER REASSIGNMENT PROCEDURES AND TREATMENTS TO CERTAIN
36	36	CHILDREN. For the purpose of transitioning a child's biological
37	37	sex as determined by the sex organs, chromosomes, and endogenous
38	38	profiles of the child or affirming the child's perception of the
39	39	child's sex if that perception is inconsistent with the child's
40	40	biological sex, a physician or health care provider may not
41	41	knowingly:
42	42	(1) perform a surgery that sterilizes the child,
43	43	including:
44	44	(A) castration;
45	45	(B) vasectomy;
46	46	(C) hysterectomy;
47	47	(D) oophorectomy;
48	48	(E) metoidioplasty;
49	49	(F) orchiectomy;
50	50	(G) penectomy;
51	51	(H) phalloplasty; and
52	52	(I) vaginoplasty;
53	53	(2) perform a mastectomy;
54	54	(3) provide, prescribe, administer, or dispense any of
55	55	the following prescription drugs that induce transient or permanent
56	56	infertility:
57	57	(A) puberty suppression or blocking prescription
58	58	drugs to stop or delay normal puberty;
59	59	(B) supraphysiologic doses of testosterone to
60	60	females; or
61	61	(C) supraphysiologic doses of estrogen to males;
62	62	or
63	63	(4) remove any otherwise healthy or non-diseased body
64	64	part or tissue.
65	65	Sec. 161.703. EXCEPTIONS. Section 161.702 does not apply
66	66	to the provision by a physician or health care provider, with the
67	67	consent of the child's parent or legal guardian, of:
68	68	(1) puberty suppression or blocking prescription
69	69	drugs for the purpose of normalizing puberty for a minor
70	70	experiencing precocious puberty; or
71	71	(2) appropriate and medically necessary procedures or
72	72	treatments to a child who:
73	73	(A) is born with a medically verifiable genetic
74	74	disorder of sex development, including:
75	75	(i) 46,XX chromosomes with virilization;
76	76	(ii) 46,XY chromosomes with
77	77	undervirilization; or
78	78	(iii) both ovarian and testicular tissue;
79	79	or
80	80	(B) does not have the normal sex chromosome
81	81	structure for male or female as determined by a physician through
82	82	genetic testing.
83	83	Sec. 161.704. PROHIBITED USE OF PUBLIC MONEY. Public money
84	84	may not directly or indirectly be used, granted, paid, or
85	85	distributed to any health care provider, medical school, hospital,
86	86	physician, or any other entity, organization, or individual that
87	87	provides or facilitates the provision of a procedure or treatment
88	88	to a child that is prohibited under Section 161.702.
89	89	Sec. 161.705. PROHIBITED STATE HEALTH PLAN REIMBURSEMENT.
90	90	The commission may not provide Medicaid reimbursement and the child
91	91	health plan program established by Chapter 62 may not provide
92	92	reimbursement to a physician or health care provider for provision
93	93	of a procedure or treatment to a child that is prohibited under
94	94	Section 161.702.
95	95	Sec. 161.706. ATTORNEY GENERAL ENFORCEMENT. (a) If the
96	96	attorney general has reason to believe that a person is committing,
97	97	has committed, or is about to commit a violation of Section 161.702,
98	98	the attorney general may bring an action to enforce this subchapter
99	99	to restrain or enjoin the person from committing, continuing to
100	100	commit, or repeating the violation.
101	101	(b) Venue for an action brought under this section is in a
102	102	district court of Travis County or the county where the violation
103	103	occurred or is about to occur.
104	104	SECTION 3. Section 32.024, Human Resources Code, is amended
105	105	by adding Subsection (pp) to read as follows:
106	106	(pp) The medical assistance program may not provide
107	107	coverage for services prohibited by Section 161.702, Health and
108	108	Safety Code, that are intended to transition a child's biological
109	109	sex as determined by the child's sex organs, chromosomes, and
110	110	endogenous profiles.
111	111	SECTION 4. Section 164.052(a), Occupations Code, is amended
112	112	to read as follows:
113	113	(a) A physician or an applicant for a license to practice
114	114	medicine commits a prohibited practice if that person:
115	115	(1) submits to the board a false or misleading
116	116	statement, document, or certificate in an application for a
117	117	license;
118	118	(2) presents to the board a license, certificate, or
119	119	diploma that was illegally or fraudulently obtained;
120	120	(3) commits fraud or deception in taking or passing an
121	121	examination;
122	122	(4) uses alcohol or drugs in an intemperate manner
123	123	that, in the board's opinion, could endanger a patient's life;
124	124	(5) commits unprofessional or dishonorable conduct
125	125	that is likely to deceive or defraud the public, as provided by
126	126	Section 164.053, or injure the public;
127	127	(6) uses an advertising statement that is false,
128	128	misleading, or deceptive;
129	129	(7) advertises professional superiority or the
130	130	performance of professional service in a superior manner if that
131	131	advertising is not readily subject to verification;
132	132	(8) purchases, sells, barters, or uses, or offers to
133	133	purchase, sell, barter, or use, a medical degree, license,
134	134	certificate, or diploma, or a transcript of a license, certificate,
135	135	or diploma in or incident to an application to the board for a
136	136	license to practice medicine;
137	137	(9) alters, with fraudulent intent, a medical license,
138	138	certificate, or diploma, or a transcript of a medical license,
139	139	certificate, or diploma;
140	140	(10) uses a medical license, certificate, or diploma,
141	141	or a transcript of a medical license, certificate, or diploma that
142	142	has been:
143	143	(A) fraudulently purchased or issued;
144	144	(B) counterfeited; or
145	145	(C) materially altered;
146	146	(11) impersonates or acts as proxy for another person
147	147	in an examination required by this subtitle for a medical license;
148	148	(12) engages in conduct that subverts or attempts to
149	149	subvert an examination process required by this subtitle for a
150	150	medical license;
151	151	(13) impersonates a physician or permits another to
152	152	use the person's license or certificate to practice medicine in
153	153	this state;
154	154	(14) directly or indirectly employs a person whose
155	155	license to practice medicine has been suspended, canceled, or
156	156	revoked;
157	157	(15) associates in the practice of medicine with a
158	158	person:
159	159	(A) whose license to practice medicine has been
160	160	suspended, canceled, or revoked; or
161	161	(B) who has been convicted of the unlawful
162	162	practice of medicine in this state or elsewhere;
163	163	(16) performs or procures a criminal abortion, aids or
164	164	abets in the procuring of a criminal abortion, attempts to perform
165	165	or procure a criminal abortion, or attempts to aid or abet the
166	166	performance or procurement of a criminal abortion;
167	167	(17) directly or indirectly aids or abets the practice
168	168	of medicine by a person, partnership, association, or corporation
169	169	that is not licensed to practice medicine by the board;
170	170	(18) performs an abortion on a woman who is pregnant
171	171	with a viable unborn child during the third trimester of the
172	172	pregnancy unless:
173	173	(A) the abortion is necessary to prevent the
174	174	death of the woman;
175	175	(B) the viable unborn child has a severe,
176	176	irreversible brain impairment; or
177	177	(C) the woman is diagnosed with a significant
178	178	likelihood of suffering imminent severe, irreversible brain damage
179	179	or imminent severe, irreversible paralysis;
180	180	(19) performs an abortion on an unemancipated minor
181	181	without the written consent of the child's parent, managing
182	182	conservator, or legal guardian or without a court order, as
183	183	provided by Section 33.003 or 33.004, Family Code, unless the
184	184	abortion is necessary due to a medical emergency, as defined by
185	185	Section 171.002, Health and Safety Code;
186	186	(20) otherwise performs an abortion on an
187	187	unemancipated minor in violation of Chapter 33, Family Code;
188	188	(21) performs or induces or attempts to perform or
189	189	induce an abortion in violation of Subchapter C, F, or G, Chapter
190	190	171, Health and Safety Code;
191	191	(22) in complying with the procedures outlined in
192	192	Sections 166.045 and 166.046, Health and Safety Code, wilfully
193	193	fails to make a reasonable effort to transfer a patient to a
194	194	physician who is willing to comply with a directive; [or]
195	195	(23) performs or delegates to another individual the
196	196	performance of a pelvic examination on an anesthetized or
197	197	unconscious patient in violation of Section 167A.002, Health and
198	198	Safety Code; or
199	199	(24) performs a gender transitioning or gender
200	200	reassignment procedure or treatment in violation of Section
201	201	161.702, Health and Safety Code.
202	202	SECTION 5. Subchapter B, Chapter 164, Occupations Code, is
203	203	amended by adding Section 164.0552 to read as follows:
204	204	Sec. 164.0552. PROHIBITED ACTS REGARDING GENDER
205	205	TRANSITIONING OR GENDER REASSIGNMENT PROCEDURES AND TREATMENTS ON
206	206	CERTAIN CHILDREN. (a) The board shall revoke the license or other
207	207	authorization to practice medicine of a physician who violates
208	208	Section 161.702, Health and Safety Code. The board shall refuse to
209	209	admit to examination or refuse to issue a license or renewal license
210	210	to a person who violates that section.
211	211	(b) The sanctions provided by Subsection (a) are in addition
212	212	to any other grounds for revocation of a license or other
213	213	authorization to practice medicine or for refusal to admit persons
214	214	to examination under this subtitle or to issue a license or renew a
215	215	license to practice medicine under this subtitle.
216	216	SECTION 6. Section 164.052, Occupations Code, as amended by
217	217	this Act, and Section 164.0552, Occupations Code, as added by this
218	218	Act, apply only to conduct that occurs on or after the effective
219	219	date of this Act. Conduct that occurs before the effective date of
220	220	this Act is governed by the law in effect on the date the conduct
221	221	occurred, and the former law is continued in effect for that
222	222	purpose.
223	223	SECTION 7. If before implementing any provision of this Act
224	224	a state agency determines that a waiver or authorization from a
225	225	federal agency is necessary for implementation of that provision,
226	226	the agency affected by the provision shall request the waiver or
227	227	authorization and may delay implementing that provision until the
228	228	waiver or authorization is granted.
229	229	SECTION 8. This Act takes effect December 1, 2023.