Texas 2023 - 88th Regular

Texas House Bill HB1873 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New	Differences
1	1	88R1396 SCL-F
2	2	By: Campos H.B. No. 1873
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to patients' rights, consumer protection, and directives
8	8	for the provision of health care services; providing an
9	9	administrative penalty.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Subchapter A, Chapter 166, Health and Safety
12	12	Code, is amended by adding Section 166.012 to read as follows:
13	13	Sec. 166.012. DIRECTIVE FOR PHYSICIAN DIAGNOSIS AND
14	14	TREATMENT. (a) A competent adult may execute a written directive
15	15	that:
16	16	(1) requires any diagnosis or treatment provided to
17	17	the adult to be provided only by a physician; and
18	18	(2) provides that if the adult is incompetent or
19	19	otherwise mentally or physically incapable of communication, only a
20	20	physician may diagnose and treat the adult.
21	21	(b) Except as provided by Subsection (c), the declarant must
22	22	sign the directive in the presence of two witnesses who qualify
23	23	under Section 166.003, at least one of whom must be a witness who
24	24	qualifies under Section 166.003(2). The witnesses must sign the
25	25	directive.
26	26	(c) The declarant, in lieu of signing in the presence of
27	27	witnesses, may sign the directive and have the signature
28	28	acknowledged before a notary public.
29	29	(d) A declarant shall notify the declarant's attending
30	30	physician of the existence of the written directive. If the
31	31	declarant is incompetent or otherwise mentally or physically
32	32	incapable of communication, another person may notify the attending
33	33	physician of the existence of the directive. The attending
34	34	physician shall make the directive a part of the declarant's
35	35	medical record.
36	36	(e) A directive described by Subsection (a) prevails over a
37	37	conflicting directive unless the conflicting directive is later
38	38	executed and states that the directive executed under this section
39	39	is revoked.
40	40	SECTION 2. Title 2, Health and Safety Code, is amended by
41	41	adding Subtitle J to read as follows:
42	42	SUBTITLE J. PROVISION OF HEALTH CARE SERVICES
43	43	CHAPTER 185. TEXAS PATIENTS' BILL OF RIGHTS
44	44	SUBCHAPTER A. GENERAL PROVISIONS
45	45	Sec. 185.001. DEFINITIONS. In this chapter:
46	46	(1) "Health care facility" means a facility licensed,
47	47	certified, registered, or otherwise authorized to administer
48	48	health care services, for profit or otherwise, to individuals in
49	49	this state in the ordinary course of business or professional
50	50	practice.
51	51	(2) "Health care practitioner" means an individual
52	52	licensed, certified, registered, or otherwise authorized to
53	53	administer health care services, for profit or otherwise, to
54	54	individuals in this state in the ordinary course of business or
55	55	practice.
56	56	(3) "Health care services" means services provided by
57	57	a health care practitioner to prevent, alleviate, cure, or heal
58	58	human illness or injury.
59	59	Sec. 185.002. PURPOSE. The purpose of this chapter is to
60	60	provide the necessary information for patients to make informed
61	61	decisions on health care services.
62	62	Sec. 185.003. APPLICABILITY. (a) Except as provided by
63	63	Subsection (b), this chapter applies to each health care facility
64	64	in this state, including hospitals, freestanding emergency medical
65	65	care facilities, hospital-owned outpatient clinics, urgent care
66	66	centers, and ambulatory surgical centers, and each health care
67	67	practitioner in this state.
68	68	(b) This chapter does not apply to a dentist, physical
69	69	therapist, or chiropractor.
70	70	Sec. 185.004. RULES. A state regulatory agency that issues
71	71	a license, certification, registration, or other authorization to a
72	72	health care facility or health care practitioner, including The
73	73	Texas Medical Board, Texas Physician Assistant Board, Texas Board
74	74	of Nursing, and executive commissioner, may adopt rules necessary
75	75	to implement this chapter.
76	76	SUBCHAPTER B. PATIENT RIGHTS
77	77	Sec. 185.051. RIGHTS RELATED TO HEALTH CARE PRACTITIONERS.
78	78	A patient in this state has the right to:
79	79	(1) be informed of the type of license a health care
80	80	practitioner holds by viewing a photo identification worn by the
81	81	practitioner in accordance with Section 185.102;
82	82	(2) be informed about whether a supervising physician
83	83	is present at the health care facility at the time the patient
84	84	receives health care services at the facility;
85	85	(3) decline health care services provided by a
86	86	nonphysician health care practitioner and instead request that a
87	87	physician provide the health care services within a reasonable
88	88	time;
89	89	(4) be informed in advance of the patient's health care
90	90	appointment of the health care practitioner scheduled to provide
91	91	health care services to the patient;
92	92	(5) avoid any penalty for the patient's refusal to
93	93	accept provision of health care services by a nonphysician health
94	94	care practitioner;
95	95	(6) be provided an initial consultation only with a
96	96	specialist who is a physician;
97	97	(7) be informed of the identity of the physician
98	98	supervising each nonphysician health care practitioner involved in
99	99	providing health care services to the patient; and
100	100	(8) be provided accurate health care information that
101	101	is not misleading or deceptive in a manner prohibited under Section
102	102	102.0015, Occupations Code.
103	103	Sec. 185.052. RIGHTS RELATED TO INFORMED CONSENT. (a) A
104	104	patient in this state has the right to:
105	105	(1) receive a clearly readable and intelligible copy
106	106	of all consent to treat forms before the patient is asked to sign
107	107	those forms;
108	108	(2) receive and execute a one-page document
109	109	authorizing only a physician to diagnose and treat the patient;
110	110	(3) receive simplified paperwork that does not require
111	111	the patient to enter duplicate information on multiple forms;
112	112	(4) execute an advance directive under Section 166.012
113	113	requiring that only a physician diagnose and treat the patient,
114	114	including when the patient is unable to communicate; and
115	115	(5) receive documentation with a clear explanation of
116	116	each proposed health care service, including medications, and any
117	117	practicable alternatives to each service.
118	118	(b) A reference on an electronic device to a consent to
119	119	treat form or another document that the patient has not received
120	120	does not satisfy the requirements of Subsection (a)(1).
121	121	Sec. 185.053. RIGHTS RELATED TO TREATMENT. A patient in
122	122	this state has the right to:
123	123	(1) if practicable, have an advocate, including a
124	124	family member or other individual, present with the patient during
125	125	the provision of health care services;
126	126	(2) receive an easily understandable summary of the
127	127	health care services provided to the patient;
128	128	(3) for hospitalized patients, have an accurate active
129	129	medication list maintained at all times while the patient remains
130	130	hospitalized; and
131	131	(4) as applicable, receive documentation stating that
132	132	the patient's treatment is deviating from the standard of care
133	133	because of cost, health benefit plan coverage, or hospital supply
134	134	shortage.
135	135	Sec. 185.054. RIGHTS RELATED TO BILLING. A patient in this
136	136	state has the right to receive:
137	137	(1) if practicable, a written estimate of the cost of
138	138	health care services, including the cost of directly paying the
139	139	health care practitioner or health care facility that provides the
140	140	services rather than paying through a health benefit plan;
141	141	(2) written notice on whether the patient's health
142	142	benefit plan covers a health care service;
143	143	(3) a written disclosure on whether any health care
144	144	practitioner who may provide health care services to the patient is
145	145	an independent contractor who bills separately; and
146	146	(4) a reduced price for health care services provided
147	147	by a nonphysician health care practitioner.
148	148	SUBCHAPTER C. REQUIREMENTS FOR HEALTH CARE FACILITIES AND
149	149	PRACTITIONERS
150	150	Sec. 185.101. PROHIBITED ABRIDGEMENT OF RIGHTS OR VIOLATION
151	151	OF RULES. A health care facility or health care practitioner may
152	152	not abridge a right described by Subchapter B or violate a rule
153	153	adopted under this chapter.
154	154	Sec. 185.102. PHOTO IDENTIFICATION REQUIREMENTS FOR HEALTH
155	155	CARE PRACTITIONERS. (a) While providing health care services to a
156	156	patient, a health care practitioner shall wear a clearly visible
157	157	photo identification that identifies the practitioner's
158	158	occupational license, certification, registration, or other
159	159	authorization issued under Title 3, Occupations Code, or the
160	160	occupational license, certification, registration, or other
161	161	authorization for which the practitioner is training under that
162	162	title.
163	163	(b) The photo identification must clearly state the health
164	164	care practitioner's occupation and may not abbreviate the
165	165	occupation.
166	166	(c) The photo identification for a health care practitioner
167	167	who is training to hold a license, certification, registration, or
168	168	other authorization under Title 3, Occupations Code, must identify
169	169	the practitioner as a student, resident, or fellow.
170	170	Sec. 185.103. INFORMATION REGARDING NONPHYSICIAN HEALTH
171	171	CARE PRACTITIONERS. A health care facility employing nonphysician
172	172	health care practitioners at a facility location shall clearly post
173	173	in each patient waiting area at the location and on all
174	174	advertisements for health care services provided at the location
175	175	that:
176	176	(1) health care services are provided by nonphysician
177	177	health care practitioners; and
178	178	(2) the patient has the right to be informed of the
179	179	identity of the supervising physician of any nonphysician health
180	180	care provider who provides health care services to the patient.
181	181	Sec. 185.104. PROVISION OF TRAINING INFORMATION. A health
182	182	care facility in this state shall post the differences in training
183	183	requirements for the health care practitioners employed by the
184	184	facility on the facility's Internet website and in each of the
185	185	facility's patient waiting areas.
186	186	SUBCHAPTER D. ENFORCEMENT
187	187	Sec. 185.151. REPORT. A patient may report a violation of a
188	188	right described by Subchapter B to:
189	189	(1) the state regulatory agency that issues a license,
190	190	certification, registration, or other authorization to a health
191	191	care practitioner, including:
192	192	(A) the Texas Medical Board for physicians;
193	193	(B) the Texas Physician Assistant Board for
194	194	physician assistants; and
195	195	(C) the Texas Board of Nursing for nurses; and
196	196	(2) the state regulatory agency that issues a license,
197	197	certification, registration, or other authorization to a health
198	198	care facility, including the commission.
199	199	Sec. 185.152. ADMINISTRATIVE PENALTY. (a) A state
200	200	regulatory agency for a health care facility or health care
201	201	practitioner, including the Texas Medical Board, the Texas
202	202	Physician Assistant Board, the Texas Board of Nursing, and the
203	203	commission, may impose an administrative penalty against a person
204	204	regulated by the agency who violates this chapter or a rule adopted
205	205	under this chapter.
206	206	(b) The assessed penalty may not be less than $100 or more
207	207	than $10,000 for each violation. Each day of a violation that
208	208	occurs before the day on which the person receives written notice of
209	209	the violation does not constitute a separate violation and shall be
210	210	considered one violation. Each day of a continuing violation that
211	211	occurs after the day on which the person receives written notice of
212	212	the violation constitutes a separate violation.
213	213	SECTION 3. Subchapter A, Chapter 102, Occupations Code, is
214	214	amended by adding Section 102.0015 to read as follows:
215	215	Sec. 102.0015. REQUIREMENTS AND PROHIBITED PRACTICES
216	216	RELATED TO QUALIFICATIONS IN ADVERTISEMENTS. (a) A person may not
217	217	make a deceptive or misleading statement or engage in a deceptive or
218	218	misleading act in advertising health care services that
219	219	misrepresents:
220	220	(1) whether the person holds a license, certification,
221	221	registration, or other authorization issued by this state to
222	222	provide the services; or
223	223	(2) the person's education, training, or clinical
224	224	expertise.
225	225	(b) A person who is advertising health care services
226	226	provided by the person shall disclose in the advertisement the
227	227	applicable license, certification, registration, or other
228	228	authorization under which the person is authorized to provide the
229	229	services.
230	230	SECTION 4. Section 102.008, Occupations Code, is amended to
231	231	read as follows:
232	232	Sec. 102.008. DISCIPLINARY ACTION. A violation of Section
233	233	102.001, 102.0015, or 102.006 is grounds for disciplinary action by
234	234	the regulatory agency that issued a license, certification, or
235	235	registration to the person who committed the violation.
236	236	SECTION 5. Each state regulatory agency that issues a
237	237	license, certification, registration, or other authorization to a
238	238	health care practitioner or health care facility, including the
239	239	Texas Medical Board, Texas Physician Assistant Board, Texas Board
240	240	of Nursing, and executive commissioner of the Health and Human
241	241	Services Commission, shall adopt rules necessary to implement
242	242	Chapter 185, Health and Safety Code, as added by this Act, not later
243	243	than January 1, 2024.
244	244	SECTION 6. Chapter 185, Health and Safety Code, as added by
245	245	this Act, applies to the provision of health care services on or
246	246	after January 1, 2024.
247	247	SECTION 7. This Act takes effect September 1, 2023.