BILL ANALYSIS



H.B. 2021
By: Berlanga
04-04-95
Committee Report (Unamended)


BACKGROUND

Federally Qualified Health Centers (FQHCs) are a provider type
under Medicare and Medicaid law. All FQHCs are nonprofit or public
health organizations located in urban and rural areas designated as
medically underserved areas or populations. A majority of patients
seen at these health centers are indigent or uninsured.

Pursuant to a federal statute, providers that automatically qualify
for FQHCs status receive federal grants as migrant, community or
homeless health centers. Additionally, the FQHCs law states that
providers meeting all requirements for receiving such grants, but
not actually receiving such grants, may apply for FQHCs status.
These providers are commonly called "look-alikes." There are
currently eight look-alikes designated in Texas. 

Currently, Texas statutes provide migrant, community and homeless
health centers the ability to contract or employ physicians or
dentists. This legislation extends the right to all FQHCs.

PURPOSE

H.B. 2021 would allow FQHCs to employ physicians and dentists in
order to allow FQHCs to bill Medicaid and Medicare directly and not
violate either the Texas Medical Practice Act or the Texas Dental
Practice Act.

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 Sec. 5.01(b), Medical Practice Act, (Article
4495b, Vernon's Texas Civil Statutes), by allowing the Texas Board
of Health to approve and certify a health organization to contract
with or employ physicians licensed by the Board if the organization
provides proof that it (1) is a non-profit organization under the
Texas Non-Profit Corporation Act, and that it (2) is organized and
operated as a migrant, community or homeless health center in
compliance with 42 United States Code (U.S.C.), Section 254b, 254c
or 256, or as a FQHC under 42 U.S.C., Section 1396d(l)(2)(B).
Deletes the reference to contracting with or employing physicians
in subsection (b)(2), thereby expanding the qualifications for
these physicians to include Subsection (b)(1) as well.

SECTION 2. Amends Article 4551n(a), Revised Statutes, by allowing
the Board to approve and certify a health organization to contract
with or employ dentists licensed by the Board if the organization
provides proof that it (1) is a non-profit organization under the
Texas Non-Profit Corporation Act, and that it (2) is organized and
operated as a migrant, community or homeless health center in
compliance with 42 U.S.C., Section 254(b), 254(c), or 256, or as a
FQHC under 42 U.S.C., Section 1396d(l)(2)(B). Deletes the reference
to contracting with or employing dentists in subsection (a)(2),
thereby expanding the qualifications for these dentists to include
subsection (a)(1) as well.

SECTION 3. Emergency clause.
           Effective date: upon passage.SUMMARY OF COMMITTEE ACTION

H.B. 2021 was considered by the Public Health Committee in a public
hearing on April 4, 1995.

The following person testified in favor of the bill:
Jose Camacho, representing Texas Association of Community Health
Centers.

The bill was reported favorably without amendment, with the
recommendation that it do pass and be printed, by a record vote of
7 Ayes, 0 Nays, 0 PNV, 2 Absent.