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.