BILL ANALYSIS C.S.H.B. 585 By: Harris 03-21-95 Committee Report (Substituted) BACKGROUND Current law does not specifically establish who should receive due process during the application phase or what standards and qualifications must be documented when physicians, podiatrists or dentists apply for hospital staff privileges. In addition, numerous hospitals around the state require a Doctor of Osteopathy (D.O.) to be residency trained, board eligible, or certified by a board recognized by either the American Medical Association or the Accreditation Council of Graduate Medical Education (ACGME), and they do not recognized comparable American Osteopathic Association (AOA) residency, board certification, or eligibility. The lack of this recognition discriminates against the equally trained osteopathic physician. PURPOSE This bill would provide physicians, podiatrists and dentists equal access to hospital staff membership and privileges during the application process. RULEMAKING AUTHORITY It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution. SECTION BY SECTION ANALYSIS SECTION 1. Amends Subsection (c) and adds Subsections (e) through (i) to Section 241.101 of the Health and Safety Code, as follows: Subsection (c) is amended to give each "physician, podiatrist, and dentist" procedural due process when applications are considered for staff membership and privileges. Subsection (e) gives hospitals the authority to require physicians, podiatrists, or dentists to document their current clinical competency and professional training and experience in the medical procedures for which they are requesting privileges. Subsection (f) prohibits a hospital from basing approval of staff membership or privileges on the type of academic medical degree held by a physician. Subsection (g) allows graduate medical education to be used as a standard or qualification for membership or privileges for a physician only if equal recognition is given to accreditation by the ACGME and the AOA. Subsection (h) Allows board certification to be used as a standard or qualification for membership and privileges for a physician only if equal recognition is given to certification programs approved by the American Board of Medical Specialties and the Bureau of Osteopathic Specialists. Subsection (i) requires a hospital's credentials committee to act expeditiously and within 90 days when processing an application from a licensed physician, podiatrist, or dentist. A hospital's governing body is required to take final action on the application within 60 days of receiving the credentials committee's recommendation, and written notification of the final decision must be made within 20 days after the action is taken. Written notification must include a reason for denial or restriction of privileges. SECTION 2. Emergency clause. Effective upon passage. COMPARISON OF ORIGINAL TO SUBSTITUTE The substitute legislation expands the procedural due-process assurances proposed in both versions of the bill to podiatrists and dentists as well as to doctors of medicine and doctors of osteopathic medicine, the latter two of which are referred to as "physicians" in the substitute bill. The substitute bill amends Section 241.101 of the Health and Safety Code, which addresses "Hospital Authority Concerning Medical Staff," instead of creating a new Subchapter as proposed in the original bill proposes. Additionally, the substitute bill deletes a provision included in the original legislation (subsection (g) in Section 1 of the bill) that would have given a district attorney jurisdiction over complaints of discrimination based on academic medical degree, training or certification. Section 241.101 already gives the Texas Department of Health authority to enforce Chapter 241 of the Health and Safety Code. SUMMARY OF COMMITTEE ACTION H.B. 585 was considered by the Public Health Committee in a public hearing on March 21, 1995. The following person testified in favor of the bill: Zachary Eugene, D.O., representing self and Texas Osteopathic Medical Association. The committee considered a complete substitute for the bill. The substitute was adopted without objection. The bill was reported favorably as substituted, with the recommendation that it do pass and be printed, by a record vote of 9 Ayes, 0 Nays, 0 PNV, and 0 Absent.