Texas 2023 - 88th Regular

Texas House Bill HB2324 Compare Versions

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1	1	88R2262 JCG-F
2	2	By: Allison H.B. No. 2324
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the regulation of certain health professionals and
8	8	health facilities; providing civil and administrative penalties;
9	9	creating a criminal offense.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Section 241.009, Health and Safety Code, is
12	12	amended by amending Subsections (b) and (c) and adding Subsection
13	13	(d) to read as follows:
14	14	(b) A hospital licensed under this chapter shall adopt a
15	15	policy requiring a health care provider providing direct patient
16	16	care at the hospital to wear a photo identification badge during all
17	17	patient encounters, unless precluded by adopted isolation or
18	18	sterilization protocols. The badge must be of sufficient size and
19	19	worn in a manner to be visible and must clearly state:
20	20	(1) at minimum the provider's first or last name;
21	21	(2) the department of the hospital with which the
22	22	provider is associated;
23	23	(3) only the type of license held by the provider as
24	24	prescribed by Subsection (c), if the provider holds a license under
25	25	Title 3, Occupations Code; and
26	26	(4) if applicable, the provider's status as a student,
27	27	intern, trainee, or resident.
28	28	(c) For purposes of Subsection (b)(3), the identification
29	29	badge of a health care provider licensed under Title 3, Occupations
30	30	Code, must clearly state only the following designations for which
31	31	the health care provider holds a license:
32	32	(1) "physician," if the provider holds a license under
33	33	Subtitle B of that title;
34	34	(2) "chiropractor," "podiatrist," "midwife,"
35	35	"physician assistant," "acupuncturist," or "surgical assistant,"
36	36	as applicable, if the provider holds a license under Subtitle C of
37	37	that title;
38	38	(3) "dentist" or "dental hygienist," as applicable, if
39	39	the provider holds a license under Subtitle D of that title;
40	40	(4) "licensed vocational nurse," "registered nurse,"
41	41	"advanced practice registered nurse [practitioner]," "nurse
42	42	midwife," "certified registered nurse anesthetist," or "clinical
43	43	nurse specialist," as applicable, if the provider holds a license
44	44	under Subtitle E of that title;
45	45	(5) "optometrist," or "therapeutic optometrist," as
46	46	applicable, if the provider holds a license under Subtitle F of that
47	47	title;
48	48	(6) "speech-language pathologist," [pathologist" or]
49	49	"audiologist," "hearing instrument fitter and dispenser,"
50	50	"licensed dyslexia practitioner," or "licensed dyslexia
51	51	therapist," as applicable, if the provider holds a license under
52	52	Subtitle G of that title;
53	53	(7) "athletic trainer," "physical therapist,"
54	54	"occupational therapist," or "massage therapist," as applicable,
55	55	if the provider holds a license under Subtitle H of that title;
56	56	(8) "medical radiologic technologist," "medical
57	57	physicist," "perfusionist," "respiratory care practitioner,"
58	58	"orthotist," or "prosthetist," as applicable, if the provider holds
59	59	a license or certificate, as appropriate, under Subtitle K of that
60	60	title; and
61	61	(9) "dietitian," if the provider holds a license under
62	62	Subtitle M of that title.
63	63	(d) For purposes of Subsection (b)(4), a person may not use
64	64	the title "resident" unless the person is a graduate of a medical
65	65	school and receiving graduate medical training.
66	66	SECTION 2. Section 241.0585, Health and Safety Code, is
67	67	amended to read as follows:
68	68	Sec. 241.0585. RECOVERY OF COSTS. If the attorney general
69	69	brings an action to collect a civil penalty authorized under or to
70	70	enforce an administrative penalty assessed under this subchapter
71	71	[Section 241.058] and the court orders the payment of the penalty,
72	72	the attorney general may recover reasonable expenses incurred in
73	73	the investigation, initiation, or prosecution of the enforcement
74	74	suit, including investigative costs, court costs, reasonable
75	75	attorney fees, witness fees, and deposition expenses.
76	76	SECTION 3. Section 241.059(b), Health and Safety Code, is
77	77	amended to read as follows:
78	78	(b) In determining the amount of the penalty, the department
79	79	shall consider:
80	80	(1) the hospital's previous violations;
81	81	(2) the seriousness of the violation;
82	82	(3) any threat to the health, safety, or rights of the
83	83	hospital's patients;
84	84	(4) the demonstrated good faith of the hospital;
85	85	(5) the amount necessary to deter a future violation;
86	86	(6) the efforts to correct the violation; and
87	87	(7) [(5)] such other matters as justice may require.
88	88	SECTION 4. Subchapter D, Chapter 254, Health and Safety
89	89	Code, is amended by adding Section 254.161 to read as follows:
90	90	Sec. 254.161. PHOTO IDENTIFICATION BADGE REQUIRED. A
91	91	facility shall adopt a policy requiring a health care provider, as
92	92	defined by Section 241.009(a), providing direct patient care at the
93	93	facility to wear a photo identification badge in the manner and
94	94	containing the information required by Section 241.009.
95	95	SECTION 5. Section 254.206(d), Health and Safety Code, is
96	96	amended to read as follows:
97	97	(d) If the person does not pay the penalty and the
98	98	enforcement of the penalty is not stayed, the penalty may be
99	99	collected. The attorney general may sue to collect the penalty.
100	100	The attorney general may recover reasonable expenses incurred in
101	101	the investigation, initiation, or prosecution of the enforcement
102	102	suit, including investigative costs, court costs, reasonable
103	103	attorney's fees, witness fees, and deposition expenses.
104	104	SECTION 6. Subchapter E, Chapter 254, Health and Safety
105	105	Code, is amended by adding Section 254.208 to read as follows:
106	106	Sec. 254.208. CIVIL PENALTY: PHOTO IDENTIFICATION
107	107	REQUIREMENT. (a) A facility that violates Section 254.161 is
108	108	liable to the state for a civil penalty not to exceed $1,000 for
109	109	each day the violation continues.
110	110	(b) The attorney general, a district or county attorney, or
111	111	a municipal attorney may sue to collect the penalty and may recover
112	112	reasonable expenses incurred in obtaining relief under this
113	113	section, including court costs, reasonable attorney's fees,
114	114	investigation costs, witness fees, and deposition expenses.
115	115	SECTION 7. The heading to Subchapter E, Chapter 101,
116	116	Occupations Code, is amended to read as follows:
117	117	SUBCHAPTER E. CERTAIN PRACTICES RELATED TO ADVERTISING AND BILLING
118	118	PROHIBITED [GROUNDS FOR LICENSE REVOCATION OR DENIAL]
119	119	SECTION 8. Section 101.201, Occupations Code, is amended by
120	120	amending Subsection (b) and adding Subsections (c) and (d) to read
121	121	as follows:
122	122	(b) False, misleading, or deceptive advertising or
123	123	advertising not readily subject to verification includes
124	124	advertising that:
125	125	(1) makes a material misrepresentation of fact or
126	126	omits a fact necessary to make the statement as a whole not
127	127	materially misleading;
128	128	(2) makes a representation likely to create an
129	129	unjustified expectation about the results of a health care service
130	130	or procedure;
131	131	(3) compares a health care professional's services
132	132	with another health care professional's services unless the
133	133	comparison can be factually substantiated;
134	134	(4) contains a testimonial;
135	135	(5) causes confusion or misunderstanding as to the
136	136	credentials, education, or licensing of a health care professional,
137	137	including using a title, term, or other words that misstate,
138	138	falsely describe, falsely hold out, or falsely detail the health
139	139	care professional's:
140	140	(A) professional skills;
141	141	(B) training;
142	142	(C) expertise;
143	143	(D) educational degree;
144	144	(E) specialty certification; or
145	145	(F) licensure;
146	146	(6) represents that health care insurance deductibles
147	147	or copayments may be waived or are not applicable to health care
148	148	services to be provided if the deductibles or copayments are
149	149	required;
150	150	(7) represents that the benefits of a health benefit
151	151	plan will be accepted as full payment when deductibles or
152	152	copayments are required;
153	153	(8) makes a representation that is designed to take
154	154	advantage of the fears or emotions of a particularly susceptible
155	155	type of patient; or
156	156	(9) represents in the use of a professional name a
157	157	title or professional identification that is associated with
158	158	another profession and the health care professional is not licensed
159	159	or otherwise authorized to practice that profession [expressly or
160	160	commonly reserved to or used by another profession or
161	161	professional].
162	162	(c) For purposes of this section, advertising that does not
163	163	include the name of the health care professional and the
164	164	professional identification required by Section 104.003 is
165	165	considered false, misleading, deceptive, or not readily subject to
166	166	verification.
167	167	(d) In this section, "advertising" includes:
168	168	(1) any printed, electronic, or oral statement, with
169	169	respect to the provision of health care services by a health care
170	170	professional:
171	171	(A) that is communicated or disseminated to the
172	172	public;
173	173	(B) that:
174	174	(i) is intended to encourage a person to use
175	175	the professional's services; or
176	176	(ii) for a commercial purpose, names the
177	177	professional in connection with the practice, profession, or
178	178	institution in which the professional provides health care
179	179	services; and
180	180	(C) the preparation, communication, or
181	181	dissemination of which is controlled by the professional or a group
182	182	to which the professional is affiliated; and
183	183	(2) any communication or statement not described by
184	184	Subdivision (1) but that is used in the regular course of the
185	185	professional's business for the purpose of promoting the
186	186	professional's services to the public, including:
187	187	(A) business cards;
188	188	(B) letterhead;
189	189	(C) signs;
190	190	(D) pamphlets;
191	191	(E) brochures;
192	192	(F) e-mails and any other communication or
193	193	statement transmitted through the internet; or
194	194	(G) audio or video communications, including
195	195	television or radio advertisements.
196	196	SECTION 9. Section 104.003, Occupations Code, is amended by
197	197	amending Subsections (b) and (c) and adding Subsection (h) to read
198	198	as follows:
199	199	(b) A person who is licensed by the Texas Medical [State]
200	200	Board [of Medical Examiners] and holds a doctor of medicine degree
201	201	shall use:
202	202	(1) physician or surgeon, M.D.;
203	203	(2) doctor, M.D.; [or]
204	204	(3) doctor of medicine, M.D.; or
205	205	(4) a designation indicating that the person is
206	206	certified or eligible for certification, as applicable, by a
207	207	certifying board of the American Board of Medical Specialties or a
208	208	successor organization.
209	209	(c) A person who is licensed by the Texas Medical [State]
210	210	Board [of Medical Examiners] and holds a doctor of osteopathy
211	211	degree shall use:
212	212	(1) physician or surgeon, D.O.;
213	213	(2) osteopathic physician or surgeon;
214	214	(3) doctor, D.O.;
215	215	(4) doctor of osteopathy;
216	216	(5) doctor of osteopathic medicine;
217	217	(6) osteopath; [or]
218	218	(7) D.O.; or
219	219	(8) a designation indicating that the person is
220	220	certified or eligible for certification, as applicable, by a
221	221	certifying board of the American Osteopathic Association or a
222	222	successor organization.
223	223	(h) Unless another provision of this title specifies
224	224	another designation, the person shall use only the following
225	225	designations for each healing art the person is licensed to
226	226	practice:
227	227	(1) "midwife," "physician assistant,"
228	228	"acupuncturist," or "surgical assistant," as applicable, if the
229	229	person holds a license under Subtitle C;
230	230	(2) "dental hygienist," if the person holds a license
231	231	to practice dental hygiene issued under Chapter 256;
232	232	(3) "licensed vocational nurse," "registered nurse,"
233	233	"advanced practice registered nurse," "nurse midwife," "certified
234	234	registered nurse anesthetist," or "clinical nurse specialist," as
235	235	applicable, if the person holds a license under Subtitle E;
236	236	(4) "speech-language pathologist," "audiologist,"
237	237	"hearing instrument fitter and dispenser," "licensed dyslexia
238	238	practitioner," or "licensed dyslexia therapist," as applicable, if
239	239	the person holds a license under Subtitle G;
240	240	(5) "athletic trainer," "physical therapist,"
241	241	"occupational therapist," or "massage therapist," as applicable,
242	242	if the person holds a license under Subtitle H;
243	243	(6) "psychologist," "psychological associate,"
244	244	"marriage and family therapist," "marriage and family therapist
245	245	associate," "professional counselor," "counselor," "chemical
246	246	dependency counselor," "social worker," "behavioral analyst," or
247	247	"assistant behavioral analyst," as applicable, if the person holds
248	248	a license under Subtitle I;
249	249	(7) "medical radiologic technologist," "medical
250	250	physicist," "perfusionist," "respiratory care practitioner,"
251	251	"orthotist," or "prosthetist," as applicable, if the person holds a
252	252	license or certificate, as appropriate, under Subtitle K; and
253	253	(8) "dietitian," if the person holds a license under
254	254	Chapter 701.
255	255	SECTION 10. Chapter 104, Occupations Code, is amended by
256	256	adding Section 104.0035 to read as follows:
257	257	Sec. 104.0035. FALSE AND DECEPTIVE ADVERTISING. A healing
258	258	art practitioner may not use advertising that is false, misleading,
259	259	or deceptive, or not readily subject to verification as provided by
260	260	Section 101.201.
261	261	SECTION 11. Section 104.005(a), Occupations Code, is
262	262	amended to read as follows:
263	263	(a) On the request of a healing art licensing board that
264	264	issues a license, certificate, or other authorization described by
265	265	[listed in] Section 104.003, the district or county attorney shall
266	266	file and prosecute appropriate judicial proceedings in the name of
267	267	the state against a person who violates Section 104.003.
268	268	SECTION 12. The heading to Section 104.007, Occupations
269	269	Code, is amended to read as follows:
270	270	Sec. 104.007. CRIMINAL PENALTIES.
271	271	SECTION 13. Chapter 104, Occupations Code, is amended by
272	272	adding Section 104.008 to read as follows:
273	273	Sec. 104.008. ADMINISTRATIVE PENALTY. (a) A healing art
274	274	licensing board that issues a license, certificate, or other
275	275	authorization described by Section 104.003, may impose an
276	276	administrative penalty on a person who:
277	277	(1) holds a license, certificate, or other
278	278	authorization issued by the healing art licensing board; and
279	279	(2) violates this chapter.
280	280	(b) The amount of an administrative penalty may not exceed
281	281	$1,000 for each violation. Each day a violation continues or occurs
282	282	is a separate violation for purposes of imposing a penalty.
283	283	(c) A proceeding to impose an administrative penalty under
284	284	this section is subject to Chapter 2001, Government Code.
285	285	SECTION 14. Section 165.156, Occupations Code, is amended
286	286	to read as follows:
287	287	Sec. 165.156. MISREPRESENTATION REGARDING ENTITLEMENT TO
288	288	PRACTICE MEDICINE. A person, partnership, trust, association, or
289	289	corporation commits an offense if the person, partnership, trust,
290	290	association, or corporation, through the use of any title,
291	291	abbreviation, description of services, designation, letters,
292	292	words, or terms, alone or in combination with any other title,
293	293	affixed on stationery or on advertisements, or in any other manner,
294	294	including oral or written communications, indicates or induces
295	295	another to believe that the person, partnership, trust,
296	296	association, or corporation is entitled to practice medicine if the
297	297	person, partnership, trust, association, or corporation is not
298	298	licensed to do so.
299	299	SECTION 15. Subchapter D, Chapter 165, Occupations Code, is
300	300	amended by adding Section 165.1565 to read as follows:
301	301	Sec. 165.1565. USE OF TITLE. (a) In this section, "medical
302	302	or medical specialty title" means:
303	303	(1) "doctor of medicine" or "M.D.";
304	304	(2) "doctor of osteopathy" or "D.O.";
305	305	(3) "physician";
306	306	(4) "surgeon";
307	307	(5) "osteopathic physician";
308	308	(6) "osteopathic surgeon";
309	309	(7) "doctor";
310	310	(8) "anesthesiologist";
311	311	(9) "cardiologist";
312	312	(10) "dermatologist";
313	313	(11) "endocrinologist";
314	314	(12) "gastroenterologist";
315	315	(13) "general practitioner";
316	316	(14) "gynecologist";
317	317	(15) "hematologist";
318	318	(16) "intensivist";
319	319	(17) "internist";
320	320	(18) "laryngologist";
321	321	(19) "nephrologist";
322	322	(20) "neurologist";
323	323	(21) "obstetrician";
324	324	(22) "oncologist";
325	325	(23) "ophthalmologist";
326	326	(24) "orthopedic surgeon";
327	327	(25) "orthopedist";
328	328	(26) "osteopath";
329	329	(27) "otologist";
330	330	(28) "otolaryngologist";
331	331	(29) "otorhinolaryngologist";
332	332	(30) "pathologist";
333	333	(31) "pediatrician";
334	334	(32) "primary care physician";
335	335	(33) "proctologist";
336	336	(34) "psychiatrist";
337	337	(35) "radiologist";
338	338	(36) "resident";
339	339	(37) "rheumatologist";
340	340	(38) "rhinologist"; or
341	341	(39) "urologist".
342	342	(b) Except as provided by Section 104.004, a person who is
343	343	not licensed to practice medicine by the board may not:
344	344	(1) use or publicly display a medical or medical
345	345	specialty title in connection with the person's name either alone
346	346	or in combination with another word or title; or
347	347	(2) indicate or induce another to believe that the
348	348	person is an attending doctor or attending physician.
349	349	SECTION 16. Section 204.203, Occupations Code, is amended
350	350	to read as follows:
351	351	Sec. 204.203. IDENTIFICATION REQUIREMENTS. A physician
352	352	assistant shall:
353	353	(1) keep the physician assistant's license available
354	354	for inspection at the physician assistant's primary place of
355	355	business; and
356	356	(2) when engaged in the physician assistant's
357	357	professional activities, wear a name tag identifying the license
358	358	holder as a physician assistant by title or the initials "P.A.".
359	359	SECTION 17. Subchapter E, Chapter 204, Occupations Code, is
360	360	amended by adding Section 204.2035 to read as follows:
361	361	Sec. 204.2035. FALSE AND DECEPTIVE ADVERTISING. A
362	362	physician assistant may not use advertising that is false,
363	363	misleading, deceptive, or not readily subject to verification as
364	364	provided by Section 101.201.
365	365	SECTION 18. Sections 301.351(a), (b), and (c), Occupations
366	366	Code, are amended to read as follows:
367	367	(a) A person who holds a license [as a registered nurse]
368	368	under this chapter[:
369	369	[(1)] is referred to as:
370	370	(1) a registered nurse or [; and
371	371	[(2) may use the abbreviation] "R.N.";
372	372	(2) a licensed vocational nurse or "L.V.N.";
373	373	(3) an advanced practice registered nurse or
374	374	"A.P.R.N.";
375	375	(4) a nurse practitioner or "N.P.";
376	376	(5) a nurse midwife;
377	377	(6) a certified registered nurse anesthetist or
378	378	"C.R.N.A."; or
379	379	(7) a clinical nurse specialist or "C.N.S.".
380	380	(b) A person who holds a license [as a vocational nurse]
381	381	under this chapter may not use the title "doctor" unless the person
382	382	also holds a license issued by the Texas Medical Board under
383	383	Subtitle B, as provided by Section 165.1565. [:
384	384	[(1) is referred to as a licensed vocational nurse or
385	385	vocational nurse; and
386	386	[(2) may use the abbreviation "L.V.N." or "V.N."]
387	387	(c) While interacting with the public in a nursing role,
388	388	each nurse shall wear a clearly legible insignia identifying the
389	389	nurse in accordance with Subsection (a) [as a registered or
390	390	vocational nurse]. The insignia may not contain information other
391	391	than:
392	392	(1) the appropriate [registered or vocational nurse]
393	393	designation;
394	394	(2) the nurse's name, certifications, academic
395	395	degrees, or practice position;
396	396	(3) the name of the employing facility or agency, or
397	397	other employer;
398	398	(4) a picture of the nurse; or
399	399	(5) any other information authorized by the board.
400	400	SECTION 19. Subchapter H, Chapter 301, Occupations Code, is
401	401	amended by adding Section 301.3515 to read as follows:
402	402	Sec. 301.3515. FALSE AND DECEPTIVE ADVERTISING. A nurse
403	403	may not use advertising that is false, misleading, deceptive, or
404	404	not readily subject to verification as provided by Section 101.201.
405	405	SECTION 20. Subchapter L, Chapter 301, Occupations Code, is
406	406	amended by adding Section 301.5545 to read as follows:
407	407	Sec. 301.5545. CRIMINAL PENALTY: CERTAIN TITLES FOR NURSING
408	408	EDUCATION PROGRAMS PROHIBITED. (a) A person who provides a nursing
409	409	education program approved under Section 301.157 or Section 301.303
410	410	commits an offense if the person uses the term "residency" or
411	411	"fellowship" in the name of that program.
412	412	(b) An offense under this section is a Class A misdemeanor.
413	413	SECTION 21. The changes in law made by this Act apply only
414	414	to conduct that occurs on or after the effective date of this Act.
415	415	Conduct that occurs before that date is governed by the law in
416	416	effect on the date the conduct occurred, and the former law is
417	417	continued in effect for that purpose.
418	418	SECTION 22. This Act takes effect September 1, 2023.