BG C.S.H.B. 935 75(R)BILL ANALYSIS PUBLIC HEALTH C.S.H.B. 935 By: Maxey 4-25-97 Committee Report (Substituted) BACKGROUND Choosing a competent doctor to perform surgery, deliver a child, or perform any other procedure can be one of life's most important decisions. Unfortunately, the information consumers need to make informed decisions about their doctor or prospective doctors is not readily available. Information such as education, hospital privileges, and nationally recognized specialty certification should be made available to the public. Furthermore, information relating to past criminal conduct and paid malpractice claims should also be disclosed. In 1996, Massachusetts enacted a similar law that has been overwhelmingly well received by consumers in that state. Choosing a competent doctor to perform surgery, to deliver a child, or to perform any other procedure can be one of life's most important decisions. PURPOSE CSHB 935 will enable consumers to make informed choices regarding the selection of a physician. RULEMAKING AUTHORITY It is the committee's opinion that this bill expressly grants additional rulemaking authority to the Texas State Board of Medical Examiners in SECTION 2 [Sec. 5.11(b)(9)(A), Sec. 5.11(g) and Sec. 5.11(h), Medical Practice Act, (Article 4495b, Vernon's Texas Civil Statutes)]. Additionally, SECTION 4(c) specifically requires the adoption of those rules by June 1, 1999. SECTION BY SECTION ANALYSIS SECTION 1. Amends Section 5.07(a), Medical Practice Act (Article 4495b, Vernon's Texas Civil Statutes) by adding "any offense not punishable by fine only" to the list of violations to be reported, and omitting "a felony, a misdemeanor involving moral turpitude." Subdivisions are renumbered to add (a)(2) which directs that a copy of the information be sent to the Texas State Board of Medical Examiners. SECTION 2. Amends Subchapter E, Medical Practice Act (Article 4495b, Vernon's Texas Civil Statutes) by adding Section 5.11 as follows: Sec. 5.11. PHYSICIAN PROFILES Subsection (a) requires the board to create a physician profile, as specified, in a a format that makes the information contained in it easily available to the public. Subsection (b) establishes that a profile must contain certain physician information as specified. Subsection (c) requires that information which is required to be included under subsection (b) and not maintained by the board in the course of its duties, be obtained from a physician at the time of license renewal. Requires the board to inform the physician that compliance with the request is mandatory, to inform the physician of the date the information will be made publicly available, and to instruct the physician regarding subsection (f) requirements for obtaining a copy and making corrections as specified. Subsection (d) establishes that this section does not prevent the board from providing explanatory information regarding the significance of categories in malpractice settlement reports. Subsection (e) prohibits the board from publicly disclosing a pending malpractice claim, other than a claim as specified by this section. Establishes that this subsection does not prevent the board form investigating and disciplining a physician on the basis of a pending malpractice claim. Subsection (f) requires the board to provide an individual physician with a copy of the physician profile if requested as specified. Requires the board to provide the physician one month from the date the copy was provided to correct any factual errors. Subsection (g) requires the board to update the information in a physician's profile annually. Requires the board to adopt a form that allows a physician to update information or provide additional information as specified. Requires the form to be made available electronically and on the Internet. Allows a physician to update information or provide additional information at any time. Allows the board to assess a fee to be paid by the physician to update the profile at a time other than the board's annual update and a fee to cover costs of including additional information that is not required. Allows the board to adopt rules concerning the type and content of additional information as specified. Subsection (h) requires the board to adopt rules as necessary to implement this section. SECTION 3. Requires each state agency, as specified, to provide a cost estimate, including methodology, regarding the establishment and administration of a profile program for persons licensed or regulated by the agency that is similar to the program established by this Act. Requires each agency to provide the estimate to the presiding officer of each house of the 76th Legislature by January 1, 1998. SECTION 4. Effective date is September 1, 1997. The changes made to Section 5.07(a), Medical Practice Act, apply only to convictions or findings of guilt made since September 1, 1997. Requires the Texas State Board of Medical Examiners to adopt rules by January 1, 1998. Requires the board to make initial physician profiles available to the public by June 1, 1999. Requires the board to raise prescribed fees in an amount as specified to cover the costs of administering the changes made by this Act. Requires the board to reduce any raised fees, as specified, not later than the second anniversary of the date the initial profiles are made publicly available. SECTION 4. Emergency clause. COMPARISON OF ORIGINAL TO SUBSTITUTE In SECTION 2, the substitute bill omits information which was originally included in HB 935, and was later deemed irrelevant for consumers. Other more pertinent information relating to clinical competence, on the other hand, has been added to CSHB 935. Furthermore, the provision concerning disclosure of malpractice settlements, arbitration awards and judgements has been narrowed to fit the definition of Sec. 5.11 (a)(15) of the Medical Practice Act, in which review actions by the board are disclosed. CSHB 935 adds a new SECTION 3 to also require other boards that regulate clinicians with direct patient contact to provide cost estimates for implementing similar programs. SECTION 4 of the substitute bill, is the original bill's SECTION 3 revised in terms of the date by which initial physician profiles must be made available; and supplemented with a new subsection (d) which refers to the fees prescribed by the State Board of Medical Examiners and provides for implementation of this Act through a capped increase in its physician licensure fee. The emergency clause in CSHB 935 has been renumbered as SECTION 5 to conform.