1-1     By:  Hamric, McCall (Senate Sponsor - Zaffirini)      H.B. No. 1534

 1-2          Danburg

 1-3           (In the Senate - Received from the House May 6, 1997;

 1-4     May 7, 1997, read first time and referred to Committee on Health

 1-5     and Human Services; May 14, 1997, reported favorably by the

 1-6     following vote:  Yeas 10, Nays 0; May 14, 1997, sent to printer.)

 1-7                            A BILL TO BE ENTITLED

 1-8                                   AN ACT

 1-9     relating to the certification of mammography systems.

1-10           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

1-11           SECTION 1.  Section 401.423(b), Health and Safety Code, is

1-12     amended to read as follows:

1-13           (b)  The department [board] shall apply under the Mammography

1-14     Quality Standards Act of 1992 (42 U.S.C. Section 263b [354]) to

1-15     become an accreditation body and carry out the certification

1-16     program requirements and to implement the standards established by

1-17     the United States Secretary of Health under that Act in this state.

1-18     If the United States Secretary of Health grants the department's

1-19     [board's] application, the department [board] shall assume those

1-20     responsibilities.

1-21           SECTION 2.  Sections 401.424(a) and (e), Health and Safety

1-22     Code, are amended to read as follows:

1-23           (a)  To receive a mammography certification under this

1-24     subchapter, the mammography system must, at a minimum:

1-25                 (1)  meet criteria at least as stringent as the

1-26     American College of Radiology mammography accreditation program;

1-27                 (2)  be specifically designed and used for the

1-28     performance of mammography;

1-29                 (3)  be operated by an individual certified as a

1-30     medical radiologic technologist under Chapter 1096, Acts of the

1-31     70th Legislature, Regular Session, 1987 (Article 4512m, Vernon's

1-32     Texas Civil Statutes), who meets, at a minimum, the requirements

1-33     for personnel who perform mammography established by the

1-34     Mammography Quality Standards Act of 1992 (42 U.S.C. Section 263b)

1-35     [has successfully completed special training in mammography]; and

1-36                 (4)  be used in a facility that:

1-37                       (A)  meets, at minimum, the requirements for

1-38     certification of the Mammography Quality Standards Act of 1992 (42

1-39     U.S.C. Section 263b [354]);

1-40                       (B)  has a licensed medical physicist specialized

1-41     in radiology under Chapter 235, Acts of the 72nd Legislature,

1-42     Regular Session, 1991 (Article 4512n, Vernon's Texas Civil

1-43     Statutes), who at least annually provides on-site consultation to

1-44     the facility, including a complete evaluation of the entire

1-45     mammography system to ensure compliance with this subchapter;

1-46                       (C)  maintains records of the consultations

1-47     required under Paragraph (B) for not less than seven years after

1-48     the date the consultation was performed;

1-49                       (D)  establishes a quality control program that

1-50     meets requirements that are at least as stringent as those of the

1-51     American College of Radiology mammography accreditation program;

1-52     and

1-53                       (E)  maintains and makes available to a patient

1-54     of the facility original mammograms performed at the facility until

1-55     the earlier of either:

1-56                             (i)  the fifth anniversary of the

1-57     mammography or,[;]

1-58                             [(ii)]  if an additional mammogram of the

1-59     same patient is not performed by the facility, the 10th anniversary

1-60     of the mammography; or

1-61                             (ii) [(iii)]  at the request of the

1-62     patient, the date the patient's medical records are forwarded to

1-63     another medical institution.

1-64           (e)  Notwithstanding any other provision of this chapter, the

 2-1     standards imposed for certification under this chapter may not be

 2-2     less stringent than the standards imposed on a facility under the

 2-3     Mammography Quality Standards Act of 1992 (42 U.S.C. Section 263b

 2-4     [354]).

 2-5           SECTION 3.  Section 401.426(a), Health and Safety Code, is

 2-6     amended to read as follows:

 2-7           (a)  A person who owns, leases, or uses or the agent of a

 2-8     person who owns, leases, or uses a mammography system must file a

 2-9     written application for certification under Section 401.424 [or

2-10     Section 401.425] on a form prescribed by the board.

2-11           SECTION 4.  Section 401.427, Health and Safety Code, is

2-12     amended to read as follows:

2-13           Sec. 401.427.  CERTIFICATION RENEWAL; FEES.  (a) A

2-14     certification is valid for three years [one year and may be renewed

2-15     annually on payment of the required renewal fee].

2-16           (b)  The board by rule may adopt a system under which

2-17     certifications under this subchapter expire on various dates during

2-18     the year.

2-19           (c)  The board shall set and collect an annual fee for

2-20     certification holders in an amount reasonable and necessary to

2-21     administer this subchapter.  A certification holder who fails to

2-22     pay the annual fee before the date set by the board shall pay the

2-23     annual fee and a late fee set by the board.  The board may revoke

2-24     the certification of a certification holder who does not pay the

2-25     annual fee and late fee before the required date.

2-26           (d)  A certification holder may renew the certification by

2-27     filing an application for renewal and paying the annual fee before

2-28     the date the certification expires.  If a certification  holder

2-29     fails to renew the certification by the required date, the

2-30     certification holder may renew the certification on payment of the

2-31     annual [renewal] fee and a late fee set by the board.  If the

2-32     certification is not renewed before the 181st day after the date on

2-33     which the certification expired, the certification holder must

2-34     apply for an original certification under this subchapter.

2-35           (e) [(d)]  A mammography system may not be used after the

2-36     expiration date of the certification unless the holder of the

2-37     expired certification has made a timely and sufficient application

2-38     for renewal of the certification as provided under Section

2-39     2001.054, Government Code, and a final determination of the

2-40     application by the board has not been made.

2-41           SECTION 5.  Section 401.430, Health and Safety Code, is

2-42     amended to read as follows:

2-43           Sec.  401.430.  INSPECTIONS.  (a) The department shall

2-44     inspect each mammography system that has not been fully certified

2-45     under the Mammography Quality Standards Act of 1992 (42 U.S.C.

2-46     Section 263b) [receives a certification under this subchapter] not

2-47     later than the 60th day after the date the certification under this

2-48     subchapter is issued.

2-49           (b)  The department shall inspect, at least once annually,

2-50     each mammography system that receives a certification under this

2-51     subchapter.

2-52           (c)  To protect the public health, the department may conduct

2-53     more frequent inspections than required under this section.

2-54           (d)  The department shall make reasonable attempts to

2-55     coordinate inspections under this section with other inspections

2-56     required under this chapter for the facility where the mammography

2-57     system is used.

2-58           (e)  After each satisfactory inspection, the department shall

2-59     issue a certificate of inspection for each mammography system

2-60     inspected.  The certificate of inspection must be posted at a

2-61     conspicuous place on or near the place where the mammography system

2-62     is used.  The certificate of inspection shall:

2-63                 (1)  specifically identify the mammography system

2-64     inspected;

2-65                 (2)  state the name and address of the facility where

2-66     the mammography system was used at the time of the inspection;  and

2-67                 (3)  state the date of the inspection.

2-68           (f)  A notice of a mammography system's failure to satisfy

2-69     department standards shall be posted:

 3-1                 (1)  on the mammography system at a conspicuous place

 3-2     if the system is a machine;  or

 3-3                 (2)  near the place where the mammography system

 3-4     practices if the system is an individual.

 3-5           (g)  If a facility's mammography system fails to meet the

 3-6     department's certification standards and the failure is a Severity

 3-7     Level I violation under the department's rules, the facility shall

 3-8     notify each patient on whom the facility performed a mammography

 3-9     during the 30 days preceding the date of the inspection that

3-10     revealed the failure.  The facility shall:

3-11                 (1)  inform the patient that the mammography system

3-12     failed to satisfy the department's certification standards;

3-13                 (2)  recommend that the patient have another mammogram

3-14     performed at a facility with a certified mammography system; and

3-15                 (3)  list the three facilities closest to the original

3-16     testing facility that have a certified mammography system.

3-17           (h)  In addition to the requirement of Subsection (g), the

3-18     department may require a facility to notify a patient of any other

3-19     failure of the facility's mammography system to meet the

3-20     department's certification standards.

3-21           (i)  To protect the public health, the board may adopt rules

3-22     concerning the grounds for posting a failure notice and the

3-23     placement and size of the failure notice, and for patient

3-24     notification under Subsections (g) and (h), as appropriate.

3-25           SECTION 6.  Section 401.425, Health and Safety Code, is

3-26     repealed.

3-27           SECTION 7.  This Act takes effect September 1, 1997.

3-28           SECTION 8.  The importance of this legislation and the

3-29     crowded condition of the calendars in both houses create an

3-30     emergency and an imperative public necessity that the

3-31     constitutional rule requiring bills to be read on three several

3-32     days in each house be suspended, and this rule is hereby suspended.

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