By: Hancock, et al. S.B. No. 1173
 
  (Schaefer, Oliverson, Klick, et al.)
 
   
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the regulation of abortion, including information
  regarding perinatal palliative care and prohibiting discriminatory
  abortions; authorizing disciplinary action; providing a civil
  remedy; creating a criminal offense.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  This Act may be cited as the Preborn
  Nondiscrimination Act.
         SECTION 2.  The legislature finds that:
               (1)  Texas has a compelling state interest in
  protecting all Texans from discrimination based on sex, race, and
  disability; and
               (2)  Texas enforces prohibitions against
  discrimination based on sex, race, and disability in various areas,
  including housing, employment, education, insurance, and health
  program and service provision.
         SECTION 3.  Chapter 161, Health and Safety Code, is amended
  by adding Subchapter X to read as follows:
  SUBCHAPTER X.  PERINATAL PALLIATIVE CARE
         Sec. 161.701.  PURPOSE OF SUBCHAPTER. The purpose of this
  subchapter is to ensure that a pregnant woman who receives a
  diagnosis of a life-threatening disability of the woman's preborn
  child is informed of the availability of perinatal palliative care.
         Sec. 161.702.  DEFINITION. In this subchapter, "perinatal
  palliative care" means the provision of comprehensive, supportive
  care to reduce the suffering of a pregnant woman, her preborn child,
  and her family, from diagnosis of the preborn child's
  life-threatening disability through the delivery and possible
  death of the child as a result of the life-threatening disability.
  The term includes medical, social, and mental health care,
  including counseling and health care provided by maternal-fetal
  medical specialists, obstetricians, neonatologists, anesthesia
  specialists, specialty nurses, clergy, social workers, and other
  individuals focused on alleviating fear and pain and ensuring the
  pregnant woman, her preborn child, and her family experience a
  supportive environment.
         Sec. 161.703.  PERINATAL PALLIATIVE CARE INFORMATIONAL
  MATERIALS. (a) The commission shall develop perinatal palliative
  care informational materials and post the materials on the
  commission's Internet website. The materials must include:
               (1)  a description of the health care and other
  services available through perinatal palliative care; and
               (2)  information about medical assistance benefits
  that may be available for prenatal care, childbirth, and perinatal
  palliative care.
         (b)  The commission shall develop, regularly update, and
  publish a geographically indexed list of all perinatal palliative
  care providers and programs in this state. The commission may
  include perinatal palliative care providers and programs in other
  states that provide care to residents of this state but may not
  include an abortion provider, as defined by Section 171.002, or an
  affiliate, as defined by Section 2272.001, Government Code, as
  added by Chapter 501 (S.B. 22), Acts of the 86th Legislature,
  Regular Session, 2019, of an abortion provider. The commission
  shall post the list of perinatal palliative care providers and
  programs, including contact information, on the commission's
  Internet website and note the providers and programs that provide
  services free of charge.
         Sec. 161.704.  PERINATAL PALLIATIVE CARE CERTIFICATION
  FORM. The commission shall develop a form on which a pregnant woman
  certifies that she has received the perinatal palliative care
  informational materials and list of the perinatal palliative care
  providers and programs described by Section 161.703.
         Sec. 161.705.  HEALTH CARE PROVIDER DUTIES ON DIAGNOSIS OF
  PREBORN CHILD'S LIFE-THREATENING DISABILITY. A health care
  provider who diagnoses a pregnant woman's preborn child as having a
  life-threatening disability shall, at the time of the diagnosis:
               (1)  provide the pregnant woman with a written copy of:
                     (A)  the perinatal palliative care informational
  materials and list of the perinatal palliative care providers and
  programs described by Section 161.703; and
                     (B)  the perinatal palliative care certification
  form described by Section 161.704; and
               (2)  obtain from the pregnant woman the signed
  perinatal palliative care certification form and place the form in
  the pregnant woman's medical records.
         Sec. 161.706.  EXCEPTION. A health care provider is not
  required to provide the perinatal palliative care informational
  materials or perinatal palliative care certification form under
  this subchapter if the health care provider verifies the pregnant
  woman's medical record contains a signed perinatal palliative care
  certification form for that pregnancy as required under Section
  161.705(2).
         SECTION 4.  Chapter 170, Health and Safety Code, is amended
  by designating Sections 170.001 and 170.002 as Subchapter A and
  adding a subchapter heading to read as follows:
  SUBCHAPTER A. GENERAL PROVISIONS; THIRD TRIMESTER
  ABORTION PROHIBITED
         SECTION 5.  Section 170.001, Health and Safety Code, is
  amended by adding Subdivision (2-a) to read as follows:
               (2-a)  "Preborn child" means an unborn child as defined
  by Section 171.061.
         SECTION 6.  Section 170.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 170.002.  PROHIBITED ACTS; EXEMPTION. (a) Except as
  provided by Subsection (b), a person may not intentionally or
  knowingly perform an abortion on a woman who is pregnant with a
  preborn [viable unborn] child during the third trimester of the
  pregnancy.
         (b)  Subsection (a) does not prohibit a person from
  performing an abortion if at the time of the abortion the person is
  a physician and concludes in good faith according to the
  physician's best medical judgment that[:
               [(1)  the fetus is not a viable fetus and the pregnancy
  is not in the third trimester;
               [(2)]  the abortion is necessary due to a medical
  emergency, as defined by Section 171.002 [to prevent the death or a
  substantial risk of serious impairment to the physical or mental
  health of the woman; or
               [(3)  the fetus has a severe and irreversible
  abnormality, identified by reliable diagnostic procedures].
         (c)  A physician who performs an abortion that, according to
  the physician's best medical judgment at the time of the abortion,
  is to abort a preborn [viable unborn] child during the third
  trimester of the pregnancy shall certify in writing to the
  commission, on a form prescribed by the commission, the medical
  indications supporting the physician's judgment that the abortion
  was authorized by Subsection (b) [(b)(2) or (3). If the physician
  certifies the abortion was authorized by Subsection (b)(3), the
  physician shall certify in writing on the form the fetal
  abnormality identified by the physician]. The certification must
  be made not later than the 30th day after the date the abortion was
  performed.
         SECTION 7.  Chapter 170, Health and Safety Code, is amended
  by adding Subchapter B to read as follows:
  SUBCHAPTER B. DISCRIMINATORY ABORTION PROHIBITED
         Sec. 170.051.  DEFINITION. In this subchapter, "disability"
  means:
               (1)  a physical or mental impairment that would
  substantially limit one or more of an individual's major life
  activities;
               (2)  an assessment referencing an individual's
  impairment described by Subdivision (1); or
               (3)  a physical disfigurement, scoliosis, dwarfism,
  Down syndrome, albinism, amelia, or any other type of physical,
  mental, or intellectual abnormality or disease.
         Sec. 170.052.  DISCRIMINATORY ABORTION PROHIBITED. A person
  may not:
               (1)  knowingly perform or attempt to perform on a
  pregnant woman an abortion based on the race, ethnicity, sex, or
  disability of the woman's preborn child, including a probability of
  diagnosis that the child has a disability; or
               (2)  use force or the threat of force to intentionally
  injure or intimidate a person to coerce the performance or
  attempted performance of an abortion based on the race, ethnicity,
  sex, or disability of the woman's preborn child, including a
  probability of diagnosis that the child has a disability.
         Sec. 170.053.  CRIMINAL PENALTY. (a) A person who violates
  Section 170.052 commits an offense. An offense under this
  subsection is a Class A misdemeanor.
         (b)  A woman on whom an abortion is performed or attempted in
  violation of Section 170.052 may not be prosecuted for a violation
  of that section or for conspiracy to commit a violation of that
  section.
         Sec. 170.054.  LICENSE SUSPENSION OR REVOCATION. A
  physician who violates Section 170.052 engages in unprofessional
  conduct for which the physician's license may be suspended or
  revoked under Chapter 164, Occupations Code.
         Sec. 170.055.  CIVIL REMEDIES. (a) A civil action may be
  brought against a person who violates Section 170.052 by:
               (1)  the woman on whom an abortion was performed or
  attempted in violation of Section 170.052;
               (2)  the father of the preborn child for an abortion
  performed or attempted on a pregnant woman in violation of Section
  170.052, unless the woman's pregnancy resulted from the father's
  criminal conduct; or
               (3)  a maternal grandparent of the preborn child for an
  abortion performed or attempted in violation of Section 170.052 on
  a pregnant woman who was less than 18 years of age at the time of the
  violation, unless the woman's pregnancy resulted from the maternal
  grandparent's criminal conduct.
         (b)  A person who brings an action under this section may
  obtain:
               (1)  injunctive relief;
               (2)  damages incurred by the person, including:
                     (A)  actual damages for all psychological,
  emotional, and physical injuries resulting from the violation of
  Section 170.052;
                     (B)  court costs; and
                     (C)  reasonable attorney's fees; or
               (3)  both injunctive relief and damages.
         (c)  An action for damages or injunctive relief under this
  section must be filed:
               (1)  in a district court in the county in which the
  woman on whom an abortion was performed or attempted in violation of
  Section 170.052 resides; and
               (2)  not later than the sixth anniversary of the date
  the abortion was performed or attempted in violation of Section
  170.052.
         (d)  The damages and injunctive relief authorized by this
  section are in addition to any other remedy available by law.
         (e)  A civil action under this section may not be brought
  against a woman on whom an abortion is performed or attempted in
  violation of Section 170.052.
         SECTION 8.  Section 171.002, Health and Safety Code, is
  amended by adding Subdivision (3-a) to read as follows:
               (3-a)  "Preborn child" means an unborn child as defined
  by Section 171.061.
         SECTION 9.  Section 171.012, Health and Safety Code, is
  amended by amending Subsection (a) and adding Subsections (g) and
  (h) to read as follows:
         (a)  Consent to an abortion is voluntary and informed only
  if:
               (1)  the physician who is to perform the abortion
  informs the pregnant woman on whom the abortion is to be performed
  of:
                     (A)  the physician's name;
                     (B)  the particular medical risks associated with
  the particular abortion procedure to be employed, including, when
  medically accurate:
                           (i)  the risks of infection and hemorrhage;
                           (ii)  the potential danger to a subsequent
  pregnancy and of infertility; and
                           (iii)  the possibility of increased risk of
  breast cancer following an induced abortion and the natural
  protective effect of a completed pregnancy in avoiding breast
  cancer;
                     (C)  the probable gestational age of the preborn
  [unborn] child at the time the abortion is to be performed; [and]
                     (D)  the medical risks associated with carrying
  the preborn child to term; and
                     (E)  the state law prohibiting abortion of a
  preborn child solely on the basis of the preborn child's race,
  ethnicity, sex, or disability as defined by Section 170.051,
  including a probability of diagnosis that the child has a
  disability;
               (2)  the physician who is to perform the abortion or the
  physician's agent informs the pregnant woman that:
                     (A)  medical assistance benefits may be available
  for prenatal care, childbirth, and neonatal care;
                     (B)  the father is liable for assistance in the
  support of the child without regard to whether the father has
  offered to pay for the abortion; and
                     (C)  public and private agencies provide
  pregnancy prevention counseling and medical referrals for
  obtaining pregnancy prevention medications or devices, including
  emergency contraception for victims of rape or incest;
               (3)  the physician who is to perform the abortion or the
  physician's agent:
                     (A)  provides the pregnant woman with the printed
  materials described by Section 171.014; and
                     (B)  informs the pregnant woman that those
  materials:
                           (i)  have been provided by the Health and
  Human Services Commission [Department of State Health Services];
                           (ii)  are accessible on an Internet website
  sponsored by the commission [department];
                           (iii)  describe the preborn [unborn] child
  and list agencies that offer alternatives to abortion; and
                           (iv)  include a list of agencies that offer
  sonogram services at no cost to the pregnant woman;
               (4)  before any sedative or anesthesia is administered
  to the pregnant woman and at least 24 hours before the abortion or
  at least two hours before the abortion if the pregnant woman waives
  this requirement by certifying that she currently lives 100 miles
  or more from the nearest abortion provider that is a facility
  licensed under Chapter 245 or a facility that performs more than 50
  abortions in any 12-month period:
                     (A)  the physician who is to perform the abortion
  or an agent of the physician who is also a sonographer certified by
  a national registry of medical sonographers performs a sonogram on
  the pregnant woman on whom the abortion is to be performed;
                     (B)  the physician who is to perform the abortion
  displays the sonogram images in a quality consistent with current
  medical practice in a manner that the pregnant woman may view them;
                     (C)  the physician who is to perform the abortion
  provides, in a manner understandable to a layperson, a verbal
  explanation of the results of the sonogram images, including a
  medical description of the dimensions of the embryo or fetus, the
  presence of cardiac activity, and the presence of external members
  and internal organs; and
                     (D)  the physician who is to perform the abortion
  or an agent of the physician who is also a sonographer certified by
  a national registry of medical sonographers makes audible the heart
  auscultation for the pregnant woman to hear, if present, in a
  quality consistent with current medical practice and provides, in a
  manner understandable to a layperson, a simultaneous verbal
  explanation of the heart auscultation;
               (5)  before receiving a sonogram under Subdivision
  (4)(A) and before the abortion is performed and before any sedative
  or anesthesia is administered, the pregnant woman completes and
  certifies with her signature an election form that states as
  follows:
  "ABORTION AND SONOGRAM ELECTION
               (1)  THE INFORMATION AND PRINTED MATERIALS
  DESCRIBED BY SECTIONS 171.012(a)(1)-(3), TEXAS HEALTH
  AND SAFETY CODE, HAVE BEEN PROVIDED AND EXPLAINED TO
  ME.
               (2)  I UNDERSTAND THE NATURE AND CONSEQUENCES OF
  AN ABORTION.
               (3)  TEXAS LAW REQUIRES THAT I RECEIVE A SONOGRAM
  PRIOR TO RECEIVING AN ABORTION.
               (4)  I UNDERSTAND THAT I HAVE THE OPTION TO VIEW
  THE SONOGRAM IMAGES.
               (5)  I UNDERSTAND THAT I HAVE THE OPTION TO HEAR
  THE HEARTBEAT.
               (6)  I UNDERSTAND THAT I AM REQUIRED BY LAW TO
  HEAR AN EXPLANATION OF THE SONOGRAM IMAGES UNLESS I
  CERTIFY IN WRITING TO ONE OF THE FOLLOWING:
               ___  I AM PREGNANT AS A RESULT OF A SEXUAL
  ASSAULT, INCEST, OR OTHER VIOLATION OF THE TEXAS PENAL
  CODE THAT HAS BEEN REPORTED TO LAW ENFORCEMENT
  AUTHORITIES OR THAT HAS NOT BEEN REPORTED BECAUSE I
  REASONABLY BELIEVE THAT DOING SO WOULD PUT ME AT RISK
  OF RETALIATION RESULTING IN SERIOUS BODILY INJURY.
               ___  I AM A MINOR AND OBTAINING AN ABORTION IN
  ACCORDANCE WITH JUDICIAL BYPASS PROCEDURES UNDER
  CHAPTER 33, TEXAS FAMILY CODE.
               [___  MY FETUS HAS AN IRREVERSIBLE MEDICAL
  CONDITION OR ABNORMALITY, AS IDENTIFIED BY RELIABLE
  DIAGNOSTIC PROCEDURES AND DOCUMENTED IN MY MEDICAL
  FILE.]
               (7)  I AM MAKING THIS ELECTION OF MY OWN FREE WILL
  AND WITHOUT COERCION.
               (8)  FOR A WOMAN WHO LIVES 100 MILES OR MORE FROM
  THE NEAREST ABORTION PROVIDER THAT IS A FACILITY
  LICENSED UNDER CHAPTER 245, TEXAS HEALTH AND SAFETY
  CODE, OR A FACILITY THAT PERFORMS MORE THAN 50
  ABORTIONS IN ANY 12-MONTH PERIOD ONLY:
               I CERTIFY THAT, BECAUSE I CURRENTLY LIVE 100
  MILES OR MORE FROM THE NEAREST ABORTION PROVIDER THAT
  IS A FACILITY LICENSED UNDER CHAPTER 245, TEXAS HEALTH
  AND SAFETY CODE, OR A FACILITY THAT PERFORMS MORE THAN
  50 ABORTIONS IN ANY 12-MONTH PERIOD, I WAIVE THE
  REQUIREMENT TO WAIT 24 HOURS AFTER THE SONOGRAM IS
  PERFORMED BEFORE RECEIVING THE ABORTION PROCEDURE. MY
  PLACE OF RESIDENCE IS:__________.
         ________________________________________
         SIGNATURE                        DATE";
               (6)  before the abortion is performed, the physician
  who is to perform the abortion receives a copy of the signed,
  written certification required by Subdivision (5); and
               (7)  the pregnant woman is provided the name of each
  person who provides or explains the information required under this
  subsection.
         (g)  If the pregnant woman's preborn child has been diagnosed
  with a life-threatening disability, the physician who is to perform
  the abortion shall, at least 24 hours before the abortion or at
  least two hours before the abortion if the pregnant woman waives
  this requirement by certifying that she currently lives 100 miles
  or more from the nearest abortion provider that is a facility
  licensed under Chapter 245 or a facility in which more than 50
  abortions are performed in any 12-month period:
               (1)  orally and in person, inform the pregnant woman of
  the availability of perinatal palliative care, as that term is
  defined by Section 161.702; and
               (2)  provide the pregnant woman with a written copy of:
                     (A)  the perinatal palliative care informational
  materials and list of the perinatal palliative care providers and
  programs described by Section 161.703; and
                     (B)  the perinatal palliative care certification
  form described by Section 161.704.
         (h)  If a pregnant woman described by Subsection (g), after
  receiving from the physician who is to perform the abortion the
  perinatal palliative care informational materials and
  certification form described by that subsection in the manner
  required by that subsection, chooses to have an abortion instead of
  continuing the pregnancy in perinatal palliative care, the
  physician may perform the abortion only after:
               (1)  the pregnant woman signs the certification form;
  and
               (2)  the physician places the signed certification form
  in the pregnant woman's medical records.
         SECTION 10.  Section 171.0121, Health and Safety Code, is
  amended to read as follows:
         Sec. 171.0121.  MEDICAL RECORD. (a) Before the abortion
  begins, a copy of the signed, written certification received by the
  physician under Section 171.012(a)(6) and, if applicable, under
  Section 161.704 must be placed in the pregnant woman's medical
  records.
         (b)  A copy of the signed, written certification required
  under Sections 171.012(a)(5) and (6) and of any signed, written
  certification required under Section 161.704 shall be retained by
  the facility where the abortion is performed until:
               (1)  the seventh anniversary of the date the
  certification [it] is signed; or
               (2)  if the pregnant woman is a minor, the later of:
                     (A)  the seventh anniversary of the date the
  certification [it] is signed; or
                     (B)  the woman's 21st birthday.
         SECTION 11.  Section 171.0122(d), Health and Safety Code, is
  amended to read as follows:
         (d)  A pregnant woman may choose not to receive the verbal
  explanation of the results of the sonogram images under Section
  171.012(a)(4)(C) if:
               (1)  the woman's pregnancy is a result of a sexual
  assault, incest, or other violation of the Penal Code that has been
  reported to law enforcement authorities or that has not been
  reported because she has a reason that she declines to reveal
  because she reasonably believes that to do so would put her at risk
  of retaliation resulting in serious bodily injury; or
               (2)  the woman is a minor and obtaining an abortion in
  accordance with judicial bypass procedures under Chapter 33, Family
  Code[; or
               [(3)  the fetus has an irreversible medical condition
  or abnormality, as previously identified by reliable diagnostic
  procedures and documented in the woman's medical file].
         SECTION 12.  Section 171.014(a), Health and Safety Code, is
  amended to read as follows:
         (a)  The department shall publish informational materials
  that include:
               (1)  the information required to be provided under
  Sections 171.012(a)(1)(B), [and] (D), and (E) and (a)(2)(A), (B),
  and (C); and
               (2)  the materials required by Sections 161.703, 
  171.015, and 171.016.
         SECTION 13.  Section 171.042, Health and Safety Code, is
  amended to read as follows:
         Sec. 171.042.  DEFINITION [DEFINITIONS].  In this
  subchapter,[:
               [(1)]  "post-fertilization [Post-fertilization] age"
  means the age of the preborn [unborn] child as calculated from the
  fusion of a human spermatozoon with a human ovum.
               [(2)  "Severe fetal abnormality" has the meaning
  assigned by Section 285.202.]
         SECTION 14.  Sections 171.043, 171.044, and 171.045, Health
  and Safety Code, are amended to read as follows:
         Sec. 171.043.  DETERMINATION OF POST-FERTILIZATION AGE
  REQUIRED.  Except as otherwise provided by Section 171.046, a
  physician may not perform or induce or attempt to perform or induce
  an abortion without, prior to the procedure:
               (1)  making a determination of the probable
  post-fertilization age of the preborn [unborn] child; or
               (2)  possessing and relying on a determination of the
  probable post-fertilization age of the preborn [unborn] child made
  by another physician.
         Sec. 171.044.  ABORTION OF PREBORN [UNBORN] CHILD OF 20 OR
  MORE WEEKS POST-FERTILIZATION AGE PROHIBITED. Except as otherwise
  provided by Section 171.046, a person may not perform or induce or
  attempt to perform or induce an abortion on a woman if it has been
  determined, by the physician performing, inducing, or attempting to
  perform or induce the abortion or by another physician on whose
  determination that physician relies, that the probable
  post-fertilization age of the preborn [unborn] child is 20 or more
  weeks.
         Sec. 171.045.  METHOD OF ABORTION. (a) This section applies
  only to an abortion authorized under Section 171.046(a)(1) or (2)
  in which:
               (1)  the probable post-fertilization age of the preborn
  [unborn] child is 20 or more weeks; or
               (2)  the probable post-fertilization age of the preborn
  [unborn] child has not been determined but could reasonably be 20 or
  more weeks.
         (b)  Except as otherwise provided by Section 171.046(a)(3),
  a physician performing an abortion under Subsection (a) shall
  terminate the pregnancy in the manner that, in the physician's
  reasonable medical judgment, provides the best opportunity for the
  preborn [unborn] child to survive.
         SECTION 15.  Section 171.046(a), Health and Safety Code, is
  amended to read as follows:
         (a)  The prohibitions and requirements under Sections
  171.043, 171.044, and 171.045(b) do not apply to an abortion
  performed if there exists a condition that, in the physician's
  reasonable medical judgment, so complicates the medical condition
  of the woman that, to avert the woman's death or a serious risk of
  substantial and irreversible physical impairment of a major bodily
  function, other than a psychological condition, it necessitates, as
  applicable:
               (1)  the immediate abortion of her pregnancy without
  the delay necessary to determine the probable post-fertilization
  age of the preborn [unborn] child;
               (2)  the abortion of her pregnancy even though the
  post-fertilization age of the preborn [unborn] child is 20 or more
  weeks; or
               (3)  the use of a method of abortion other than a method
  described by Section 171.045(b).
         SECTION 16.  Section 285.202(a), Health and Safety Code, is
  amended to read as follows:
         (a)  In this section, "medical emergency" means[:
               [(1)]  a condition exists that, in a physician's good
  faith clinical judgment, complicates the medical condition of the
  pregnant woman and necessitates the immediate abortion of her
  pregnancy to avert her death or to avoid a serious risk of
  substantial impairment of a major bodily function[; or
               [(2)  the fetus has a severe fetal abnormality].
         SECTION 17.  Section 164.052(a), Occupations Code, is
  amended to read as follows:
         (a)  A physician or an applicant for a license to practice
  medicine commits a prohibited practice if that person:
               (1)  submits to the board a false or misleading
  statement, document, or certificate in an application for a
  license;
               (2)  presents to the board a license, certificate, or
  diploma that was illegally or fraudulently obtained;
               (3)  commits fraud or deception in taking or passing an
  examination;
               (4)  uses alcohol or drugs in an intemperate manner
  that, in the board's opinion, could endanger a patient's life;
               (5)  commits unprofessional or dishonorable conduct
  that is likely to deceive or defraud the public, as provided by
  Section 164.053, or injure the public;
               (6)  uses an advertising statement that is false,
  misleading, or deceptive;
               (7)  advertises professional superiority or the
  performance of professional service in a superior manner if that
  advertising is not readily subject to verification;
               (8)  purchases, sells, barters, or uses, or offers to
  purchase, sell, barter, or use, a medical degree, license,
  certificate, or diploma, or a transcript of a license, certificate,
  or diploma in or incident to an application to the board for a
  license to practice medicine;
               (9)  alters, with fraudulent intent, a medical license,
  certificate, or diploma, or a transcript of a medical license,
  certificate, or diploma;
               (10)  uses a medical license, certificate, or diploma,
  or a transcript of a medical license, certificate, or diploma that
  has been:
                     (A)  fraudulently purchased or issued;
                     (B)  counterfeited; or
                     (C)  materially altered;
               (11)  impersonates or acts as proxy for another person
  in an examination required by this subtitle for a medical license;
               (12)  engages in conduct that subverts or attempts to
  subvert an examination process required by this subtitle for a
  medical license;
               (13)  impersonates a physician or permits another to
  use the person's license or certificate to practice medicine in
  this state;
               (14)  directly or indirectly employs a person whose
  license to practice medicine has been suspended, canceled, or
  revoked;
               (15)  associates in the practice of medicine with a
  person:
                     (A)  whose license to practice medicine has been
  suspended, canceled, or revoked; or
                     (B)  who has been convicted of the unlawful
  practice of medicine in this state or elsewhere;
               (16)  performs or procures a criminal abortion, aids or
  abets in the procuring of a criminal abortion, attempts to perform
  or procure a criminal abortion, or attempts to aid or abet the
  performance or procurement of a criminal abortion;
               (17)  directly or indirectly aids or abets the practice
  of medicine by a person, partnership, association, or corporation
  that is not licensed to practice medicine by the board;
               (18)  performs an abortion on a woman who is pregnant
  with a preborn [viable unborn] child during the third trimester of
  the pregnancy unless[:
                     [(A)]  the abortion is necessary due to a medical
  emergency, as defined by Section 171.002, Health and Safety Code 
  [to prevent the death of the woman;
                     [(B)  the viable unborn child has a severe,
  irreversible brain impairment; or
                     [(C)  the woman is diagnosed with a significant
  likelihood of suffering imminent severe, irreversible brain damage
  or imminent severe, irreversible paralysis];
               (19)  performs an abortion on an unemancipated minor
  without the written consent of the child's parent, managing
  conservator, or legal guardian or without a court order, as
  provided by Section 33.003 or 33.004, Family Code, unless the
  abortion is necessary due to a medical emergency, as defined by
  Section 171.002, Health and Safety Code;
               (20)  otherwise performs an abortion on an
  unemancipated minor in violation of Chapter 33, Family Code;
               (21)  performs or induces or attempts to perform or
  induce an abortion in violation of Subchapter C, F, or G, Chapter
  171, Health and Safety Code; [or]
               (22)  in complying with the procedures outlined in
  Sections 166.045 and 166.046, Health and Safety Code, wilfully
  fails to make a reasonable effort to transfer a patient to a
  physician who is willing to comply with a directive; or
               (23)  performs or attempts to perform an abortion or
  engages in other conduct in violation of Section 170.052, Health
  and Safety Code.
         SECTION 18.  Section 164.055(b), Occupations Code, is
  amended to read as follows:
         (b)  The sanctions provided by Subsection (a) are in addition
  to any other grounds for refusal to admit persons to examination
  under this subtitle or to issue a license or renew a license to
  practice medicine under this subtitle. The criminal penalties
  provided by Section 165.152 do not apply to a violation of Section
  170.002 or 170.052, Health and Safety Code, or Subchapter C, F, or
  G, Chapter 171, Health and Safety Code.
         SECTION 19.  The following provisions of the Health and
  Safety Code are repealed:
               (1)  Section 171.046(c); and
               (2)  Sections 285.202(a-1) and (a-2).
         SECTION 20.  Not later than December 1, 2021:
               (1)  the Health and Human Services Commission shall:
                     (A)  develop the perinatal palliative care
  informational materials, list of perinatal palliative care
  providers and programs, and perinatal palliative care
  certification form required by Subchapter X, Chapter 161, Health
  and Safety Code, as added by this Act; and
                     (B)  update any forms and informational materials
  under Subchapter B, Chapter 171, Health and Safety Code, as amended
  by this Act; and
               (2)  the executive commissioner of the Health and Human
  Services Commission shall adopt any rules necessary to implement
  Subchapter X, Chapter 161, Health and Safety Code, as added by this
  Act, and Subchapter B, Chapter 171, Health and Safety Code, as
  amended by this Act.
         SECTION 21.  (a)  Subchapter X, Chapter 161, Health and
  Safety Code, as added by this Act, applies only to a diagnosis of a
  life-threatening disability of a pregnant woman's preborn child
  made on or after January 1, 2022.
         (b)  Chapter 170, Health and Safety Code, as amended by this
  Act, Subchapters B and C, Chapter 171, Health and Safety Code, as
  amended by this Act, and Chapter 164, Occupations Code, as amended
  by this Act, apply only to an abortion performed, induced, or
  attempted or other conduct that occurred on or after January 1,
  2022. An abortion performed, induced, or attempted or other
  conduct that occurred before that date is governed by the law in
  effect immediately before the effective date of this Act, and that
  law is continued in effect for that purpose.
         SECTION 22.  It is the intent of the legislature that every
  provision, section, subsection, sentence, clause, phrase, or word
  of this Act and every application of the provisions of this Act to
  each person or entity are severable from each other. If a court for
  any reason finds any application of any provision of this Act to any
  person, group of persons, or circumstances to be invalid, the
  remaining applications of that provision to all other persons and
  circumstances shall be severed and may not be affected.
         SECTION 23.  This Act takes effect September 1, 2021.