89R13710 EAS-F
By: Campos H.B. No. 3588
A BILL TO BE ENTITLED
AN ACT
relating to patients' rights, consumer protection, and directives
for the provision of health care services; providing an
administrative penalty.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter A, Chapter 166, Health and Safety
Code, is amended by adding Section 166.012 to read as follows:
Sec. 166.012. DIRECTIVE FOR PHYSICIAN DIAGNOSIS AND
TREATMENT. (a) A competent adult may execute a written directive
that:
(1) requires any diagnosis or treatment provided to
the adult to be provided only by a physician; and
(2) provides that if the adult is incompetent or
otherwise mentally or physically incapable of communication, only a
physician may diagnose and treat the adult.
(b) Except as provided by Subsection (c), the declarant must
sign the directive in the presence of two witnesses who qualify
under Section 166.003, at least one of whom must be a witness who
qualifies under Section 166.003(2). The witnesses must sign the
directive.
(c) The declarant, in lieu of signing in the presence of
witnesses, may sign the directive and have the signature
acknowledged before a notary public.
(d) A declarant shall notify the declarant's attending
physician of the existence of the written directive. If the
declarant is incompetent or otherwise mentally or physically
incapable of communication, another person may notify the attending
physician of the existence of the directive. The attending
physician shall make the directive a part of the declarant's
medical record.
(e) A directive described by Subsection (a) prevails over a
conflicting directive unless the conflicting directive is later
executed and states that the directive executed under this section
is revoked.
SECTION 2. Title 2, Health and Safety Code, is amended by
adding Subtitle K to read as follows:
SUBTITLE K. PROVISION OF HEALTH CARE SERVICES
CHAPTER 189. TEXAS PATIENTS' BILL OF RIGHTS
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 189.001. DEFINITIONS. In this chapter:
(1) "Health care facility" means a facility licensed,
certified, registered, or otherwise authorized to administer
health care services, for profit or otherwise, to individuals in
this state in the ordinary course of business or professional
practice.
(2) "Health care practitioner" means an individual
licensed, certified, registered, or otherwise authorized to
administer health care services, for profit or otherwise, to
individuals in this state in the ordinary course of business or
practice.
(3) "Health care services" means services provided by
a health care practitioner to prevent, alleviate, cure, or heal
human illness or injury.
Sec. 189.002. PURPOSE. The purpose of this chapter is to
provide the necessary information for patients to make informed
decisions on health care services.
Sec. 189.003. APPLICABILITY. (a) Except as provided by
Subsection (b), this chapter applies to each health care facility
in this state, including hospitals, freestanding emergency medical
care facilities, hospital-owned outpatient clinics, urgent care
centers, and ambulatory surgical centers, and each health care
practitioner in this state.
(b) This chapter does not apply to a dentist, physical
therapist, or chiropractor.
Sec. 189.004. RULES. Each state regulatory agency that
issues a license, certification, registration, or other
authorization to a health care facility or health care
practitioner, including the Texas Medical Board, Texas Physician
Assistant Board, and Texas Board of Nursing, and the executive
commissioner shall adopt rules necessary to implement this chapter.
SUBCHAPTER B. PATIENT RIGHTS
Sec. 189.051. RIGHTS RELATED TO HEALTH CARE PRACTITIONERS.
A patient in this state has the right to:
(1) be informed of the type of license a health care
practitioner holds by viewing a photo identification worn by the
practitioner in accordance with Section 189.102;
(2) be informed about whether a supervising physician
is present at the health care facility at the time the patient
receives health care services at the facility;
(3) decline health care services provided by a
nonphysician health care practitioner and instead request that a
physician provide the health care services within a reasonable
time;
(4) be informed in advance of the patient's health care
appointment of the health care practitioner scheduled to provide
health care services to the patient;
(5) avoid any penalty for the patient's refusal to
accept provision of health care services by a nonphysician health
care practitioner;
(6) be provided an initial consultation only with a
specialist who is a physician;
(7) be informed of the identity of the physician
supervising each nonphysician health care practitioner involved in
providing health care services to the patient; and
(8) be provided accurate health care information that
is not misleading or deceptive in a manner prohibited under Section
102.0015, Occupations Code.
Sec. 189.052. RIGHTS RELATED TO INFORMED CONSENT. (a) A
patient in this state has the right to:
(1) receive a clearly readable and intelligible copy
of all consent to treat forms before the patient is asked to sign
those forms;
(2) receive and execute a one-page document
authorizing only a physician to diagnose and treat the patient;
(3) receive simplified paperwork that does not require
the patient to enter duplicate information on multiple forms;
(4) execute an advance directive under Section 166.012
requiring that only a physician diagnose and treat the patient,
including when the patient is unable to communicate; and
(5) receive documentation with a clear explanation of
each proposed health care service, including medications, and any
practicable alternatives to each service.
(b) A reference on an electronic device to a consent to
treat form or another document that the patient has not received
does not satisfy the requirements of Subsection (a)(1).
Sec. 189.053. RIGHTS RELATED TO TREATMENT. A patient in
this state has the right to:
(1) if practicable, have an advocate, including a
family member or other individual, present with the patient during
the provision of health care services;
(2) receive an easily understandable summary of the
health care services provided to the patient;
(3) for hospitalized patients, have an accurate active
medication list maintained at all times while the patient remains
hospitalized; and
(4) as applicable, receive documentation stating that
the patient's treatment is deviating from the standard of care
because of cost, health benefit plan coverage, or hospital supply
shortage.
Sec. 189.054. RIGHTS RELATED TO BILLING. A patient in this
state has the right to receive:
(1) if practicable, a written estimate of the cost of
health care services, including the cost of directly paying the
health care practitioner or health care facility that provides the
services rather than paying through a health benefit plan;
(2) written notice on whether the patient's health
benefit plan covers a health care service;
(3) a written disclosure on whether any health care
practitioner who may provide health care services to the patient is
an independent contractor who bills separately; and
(4) a reduced price for health care services provided
by a nonphysician health care practitioner.
SUBCHAPTER C. REQUIREMENTS FOR HEALTH CARE FACILITIES AND
PRACTITIONERS
Sec. 189.101. PROHIBITED ABRIDGEMENT OF RIGHTS OR VIOLATION
OF RULES. A health care facility or health care practitioner may
not abridge a right described by Subchapter B or violate a rule
adopted under this chapter.
Sec. 189.102. PHOTO IDENTIFICATION REQUIREMENTS FOR HEALTH
CARE PRACTITIONERS. (a) While providing health care services to a
patient, a health care practitioner shall wear a clearly visible
photo identification that identifies the practitioner's
occupational license, certification, registration, or other
authorization issued under Title 3, Occupations Code, or the
occupational license, certification, registration, or other
authorization for which the practitioner is training under that
title.
(b) The photo identification must clearly state the health
care practitioner's occupation and may not abbreviate the
occupation.
(c) The photo identification for a health care practitioner
who is training to hold a license, certification, registration, or
other authorization under Title 3, Occupations Code, must identify
the practitioner as a student, resident, or fellow.
Sec. 189.103. INFORMATION REGARDING NONPHYSICIAN HEALTH
CARE PRACTITIONERS. A health care facility employing nonphysician
health care practitioners at a facility location shall clearly post
in each patient waiting area at the location and on all
advertisements for health care services provided at the location
that:
(1) health care services are provided by nonphysician
health care practitioners; and
(2) the patient has the right to be informed of the
identity of the supervising physician of any nonphysician health
care provider who provides health care services to the patient.
Sec. 189.104. PROVISION OF TRAINING INFORMATION. A health
care facility in this state shall post the differences in training
requirements for the health care practitioners employed by the
facility on the facility's Internet website and in each of the
facility's patient waiting areas.
SUBCHAPTER D. ENFORCEMENT
Sec. 189.151. REPORT. A patient may report a violation of a
right described by Subchapter B to:
(1) the state regulatory agency that issues a license,
certification, registration, or other authorization to a health
care practitioner, including:
(A) the Texas Medical Board for physicians;
(B) the Texas Physician Assistant Board for
physician assistants; and
(C) the Texas Board of Nursing for nurses; and
(2) the state regulatory agency that issues a license,
certification, registration, or other authorization to a health
care facility, including the commission.
Sec. 189.152. ADMINISTRATIVE PENALTY. (a) A state
regulatory agency for a health care facility or health care
practitioner, including the Texas Medical Board, the Texas
Physician Assistant Board, the Texas Board of Nursing, and the
commission, may impose an administrative penalty against a person
regulated by the agency who violates this chapter or a rule adopted
under this chapter.
(b) The assessed penalty may not be less than $100 or more
than $10,000 for each violation. Each day of a violation that
occurs before the day on which the person receives written notice of
the violation does not constitute a separate violation and shall be
considered one violation. Each day of a continuing violation that
occurs after the day on which the person receives written notice of
the violation constitutes a separate violation.
SECTION 3. Subchapter A, Chapter 102, Occupations Code, is
amended by adding Section 102.0015 to read as follows:
Sec. 102.0015. REQUIREMENTS AND PROHIBITED PRACTICES
RELATED TO QUALIFICATIONS IN ADVERTISEMENTS. (a) A person may not
make a deceptive or misleading statement or engage in a deceptive or
misleading act in advertising health care services that
misrepresents:
(1) whether the person holds a license, certification,
registration, or other authorization issued by this state to
provide the services; or
(2) the person's education, training, or clinical
expertise.
(b) A person who is advertising health care services
provided by the person shall disclose in the advertisement the
applicable license, certification, registration, or other
authorization under which the person is authorized to provide the
services.
SECTION 4. Section 102.008, Occupations Code, is amended to
read as follows:
Sec. 102.008. DISCIPLINARY ACTION. A violation of Section
102.001, 102.0015, or 102.006 is grounds for disciplinary action by
the regulatory agency that issued a license, certification, or
registration to the person who committed the violation.
SECTION 5. Each state regulatory agency that issues a
license, certification, registration, or other authorization to a
health care practitioner or health care facility, including the
Texas Medical Board, Texas Physician Assistant Board, and Texas
Board of Nursing, and the executive commissioner of the Health and
Human Services Commission shall adopt rules necessary to implement
Chapter 189, Health and Safety Code, as added by this Act, not later
than January 1, 2026.
SECTION 6. Chapter 189, Health and Safety Code, as added by
this Act, applies to the provision of health care services on or
after January 1, 2026.
SECTION 7. This Act takes effect September 1, 2025.