Texas 2025 - 89th Regular

Texas House Bill HB2747 Compare Versions

Version 1 (Old)

Version 2 (New)

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1	1		By: Frank H.B. No. 2747
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4	6		A BILL TO BE ENTITLED
5	7		AN ACT
6	8		relating to requiring certain health care entities to submit notice
7	9		of material change transactions to the attorney general and the
8	10		attorney general's authority to conduct certain related studies;
9	11		imposing civil and administrative penalties.
10	12		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	13		SECTION 1. Healthcare patients and consumers benefit when
12	14		there are robust markets for goods and services, in which providers
13	15		of coverage and care compete to offer higher-quality care and
14	16		better prices. Consolidation in healthcare markets has reduced
15	17		competition and driven up prices. The purpose of this Act is to
16	18		promote competitive markets by strengthening the state's ability to
17	19		enforce laws and prevent anti-competitive behavior.
18	20		SECTION 2. Title 2, Business & Commerce Code, is amended by
19	21		adding Chapter 15A to read as follows:
20	22		CHAPTER 15A. MATERIAL CHANGE TRANSACTIONS INVOLVING HEALTH CARE
21	23		ENTITIES
22	24		SUBCHAPTER A. GENERAL PROVISIONS
23	25		Sec. 15A.0001. DEFINITIONS. In this chapter:
24	26		(1) "Attorney general" and "person" have the meanings
25	27		assigned by Section 15.03.
26	28		(2) "Health care entity" means a health care provider,
27	29		health care facility, provider organization, pharmacy benefit
28	30		manager, or health carrier that offers a health benefit plan in this
29	31		state.
30	32		(3) "Health care facility" means a facility licensed
31	33		to provide health care services, including:
32	34		(A) a hospital or other inpatient facility for
33	35		providing health care services;
34	36		(B) a health system consisting of jointly owned
35	37		or managed health care entities;
36	38		(C) a skilled nursing facility licensed under
37	39		Chapter 242, Health and Safety Code;
38	40		(D) an ambulatory surgical center licensed under
39	41		Chapter 243, Health and Safety Code;
40	42		(E) a freestanding emergency medical care
41	43		facility licensed under Chapter 254, Health and Safety Code;
42	44		(F) a general residential operation licensed
43	45		under Chapter 42, Human Resources Code, that provides treatment
44	46		services;
45	47		(G) a diagnostic, laboratory, or imaging center;
46	48		(H) an outpatient clinic licensed in this state
47	49		to provide health care services; or
48	50		(I) a rehabilitation center or other therapeutic
49	51		center licensed in this state to provide health care services.
50	52		(4) "Health care provider" means an individual
51	53		qualified or licensed to perform or provide health care services in
52	54		this state.
53	55		(5) "Health care services" means:
54	56		(A) services provided for the care, prevention,
55	57		diagnosis, treatment, cure, or relief of a medical, dental, or
56	58		behavioral health condition, including:
57	59		(i) inpatient, outpatient, habilitative,
58	60		rehabilitative, dental, palliative, therapeutic, supportive, home
59	61		health, or behavioral services provided by a health care entity;
60	62		(ii) retail and specialty pharmacy
61	63		services, including drugs, devices, and medical supplies provided
62	64		by a pharmacy; and
63	65		(iii) performance of functions to refer,
64	66		arrange, or coordinate health care services;
65	67		(B) equipment used to provide services described
66	68		by Paragraph (A), including durable medical equipment and
67	69		diagnostic, infusion, and surgical devices; and
68	70		(C) technology associated with the provision of
69	71		services and equipment described by Paragraphs (A) and (B),
70	72		including telehealth services, telemedicine medical services,
71	73		electronic health records, software, claims processors, and
72	74		utilization systems.
73	75		(6) "Health carrier" has the meaning assigned by
74	76		Section 1507.002, Insurance Code.
75	77		(7) "Management services organization" means an
76	78		organization or entity that contracts with a health care provider
77	79		or provider organization to perform management or administrative
78	80		services relating to, supporting, or facilitating the provision of
79	81		health care services.
80	82		(8) "Material change transaction" means a transaction
81	83		that entails a material change to ownership, operations, or
82	84		governance structure of a legal entity.
83	85		(9) "Pharmacy benefit manager" has the meaning
84	86		assigned by Section 4151.151, Insurance Code.
85	87		(10) "Provider organization" means an incorporated or
86	88		unincorporated corporation, partnership, business trust,
87	89		association, or organized group of persons that is in the business
88	90		of health care service delivery or management and that represents
89	91		at least one health care provider in contracting with a health
90	92		carrier for the payment of health care services. The term includes
91	93		a physician organization, physician-hospital organization,
92	94		independent practice association, provider network, accountable
93	95		care organization, management services organization, or other
94	96		organization that contracts with a health carrier for the payment
95	97		of health care services.
96	98		Sec. 15A.0002. APPLICABILITY OF CHAPTER TO MATERIAL CHANGE
97	99		TRANSACTIONS; EXCEPTIONS. (a) This chapter applies only to the
98	100		following material change transactions, whether occurring as a
99	101		single transaction or a series of related transactions within a
100	102		consecutive 12-month period:
101	103		(1) a merger that includes one or more health care
102	104		entities;
103	105		(2) a sale or other acquisition, including by lease,
104	106		transfer, exchange, option, receipt through conveyance, and
105	107		creation of a joint venture, of:
106	108		(A) one or more health care entities, including
107	109		insolvent health care entities; or
108	110		(B) a material amount of the assets or operations
109	111		of one or more health care entities;
110	112		(3) a contract or other arrangement, including an
111	113		association, partnership, or joint venture, that results in a
112	114		person acquiring direct or indirect control over all or a
113	115		substantial part of a health care entity's operations or
114	116		governance;
115	117		(4) the formation of a partnership, joint venture,
116	118		accountable care organization, parent organization, or management
117	119		services organization for the purpose of administering contracts
118	120		with health carriers, third-party administrators, pharmacy benefit
119	121		managers, or health care providers;
120	122		(5) the sale, purchase, lease, affiliation, or
121	123		transfer of control of a health care entity's board of directors or
122	124		other governing body; or
123	125		(6) a real estate sale or lease agreement involving a
124	126		material amount of health care entity assets.
125	127		(b) This chapter does not apply to the following:
126	128		(1) a clinical affiliation of health care entities
127	129		formed solely to collaborate on clinical trials;
128	130		(2) a graduate medical education program; or
129	131		(3) an offer of employment to, or the hiring of, not
130	132		more than one physician.
131	133		Sec. 15A.0003. CONFIDENTIALITY OF CERTAIN INFORMATION. (a)
132	134		All documents and other information provided to the attorney
133	135		general under this chapter, including the notice required under
134	136		Section 15A.0051, are not public information under Chapter 552,
135	137		Government Code, and may not be released or made public on subpoena
136	138		or otherwise except as provided by this section.
137	139		(b) The attorney general may release documents or
138	140		information:
139	141		(1) with the consent of the entity that submitted the
140	142		information; or
141	143		(2) to an expert or consultant under contract with the
142	144		attorney general solely for the purpose of conducting or aiding in
143	145		the creation of a study under Section 15A.0101, provided that the
144	146		expert or consultant is bound by the same confidentiality
145	147		requirements as the attorney general.
146	148		SUBCHAPTER B. NOTICE OF MATERIAL CHANGE TRANSACTIONS
147	149		Sec. 15A.0051. REQUIRED NOTICE OF PROPOSED MATERIAL CHANGE
148	150		TRANSACTIONS. (a) A health care entity shall submit written notice
149	151		to the attorney general of any material change transaction
150	152		involving the entity not less than 90 days before the date the
151	153		change is to take effect.
152	154		(b) The attorney general by rule shall prescribe the method
153	155		and form of the written notice required under this section.
154	156		Sec. 15A.0052. CIVIL PENALTY; INJUNCTION. (a) A person who
155	157		violates Section 15A.0051 is liable to this state for a civil
156	158		penalty in an amount not to exceed $10,000 for each violation.
157	159		(b) The attorney general may bring an action to:
158	160		(1) recover the civil penalty imposed by Subsection
159	161		(a); and
160	162		(2) restrain or enjoin a person from violating Section
161	163		15A.0051.
162	164		(c) The attorney general may recover reasonable attorney's
163	165		fees and other reasonable expenses incurred in investigating and
164	166		bringing an action under this section.
165	167		(d) The attorney general shall deposit a civil penalty
166	168		collected under this section in the state treasury to the credit of
167	169		the general revenue fund. Money deposited under this section may
168	170		only be appropriated to the attorney general for the purpose of
169	171		operating the attorney general's antitrust division.
170	172		SUBCHAPTER C. MARKET STUDIES
171	173		Sec. 15A.0101. STUDIES ON HEALTH CARE MARKETS. (a) The
172	174		attorney general may conduct studies on the following topics:
173	175		(1) the conditions of a health care market in this
174	176		state or in a region or political subdivision of this state,
175	177		including:
176	178		(A) the degree of health care entity ownership or
177	179		other concentration;
178	180		(B) the strength of competitive forces on price
179	181		and quality of health care services; and
180	182		(C) trends in the price, quality, and
181	183		availability of health care services; and
182	184		(2) the impacts of completed material change
183	185		transactions on a market.
184	186		(b) The attorney general may request necessary documents or
185	187		other information from health care and other relevant entities
186	188		involved in the health care market to conduct the studies required
187	189		by this section.
188	190		(c) Entities shall provide requested information not later
189	191		than the 30th day after the date of the request.
190	192		Sec. 15A.0102. ADMINISTRATIVE PENALTY. The attorney
191	193		general may assess an administrative penalty in an amount not to
192	194		exceed $1,000 against an entity that does not submit the requested
193	195		information in accordance with Section 15A.0101. Each day a
194	196		violation continues is considered a separate violation for purposes
195	197		of imposing the administrative penalty under this section.
196	198		SECTION 3. This Act takes effect September 1, 2025.