By Hirschi                                      H.B. No. 2452

      75R5314 PB-D                           

                                A BILL TO BE ENTITLED

 1-1                                   AN ACT

 1-2     relating to peer review of physicians.

 1-3           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

 1-4           SECTION 1.  Section 3.02, Medical Practice Act (Article

 1-5     4495b, Vernon's Texas Civil Statutes), is amended to read as

 1-6     follows:

 1-7           Sec. 3.02.  LICENSE RENEWALS.  (a)  On application on forms

 1-8     provided by the board for this purpose and receipt of  renewal

 1-9     fees, licenses shall be renewed annually by the board.

1-10           (b)  In addition to any other renewal requirements adopted by

1-11     the board, the board shall require each physician who renews a

1-12     license under this Act to disclose to the board in writing in the

1-13     license renewal form whether the physician has lost, during the two

1-14     years preceding the date of the renewal application, the

1-15     physician's privilege to practice medicine as a result of a

1-16     disciplinary action adopted by a medical peer review committee, and

1-17     if so, where the disciplinary action occurred.  For purposes of

1-18     this subsection, "disciplinary action adopted by a medical peer

1-19     review committee" means an action taken by a medical peer review

1-20     committee  under Section 5.06(i) of this Act.

1-21           (c)  The board by rule may adopt a system under which

1-22     registrations expire on various dates during the year.  The date

1-23     for license cancellation due to nonpayment shall be adjusted

1-24     accordingly.  For the year in which the expiration date is changed,

 2-1     registration fees payable on or before January 1 shall be prorated

 2-2     on a monthly basis so that each registrant shall pay only that

 2-3     portion of the registration fee which is allocable to the number of

 2-4     months during which the registration is valid.  On renewal of the

 2-5     registration on the new expiration date, the total registration fee

 2-6     is payable.

 2-7           SECTION 2.  Section 4.14, Medical Practice Act (Article

 2-8     4495b, Vernon's Texas Civil Statutes), is amended to read as

 2-9     follows:

2-10           Sec. 4.14.  REPORT OF BOARD ACTIONS.  (a)  The board shall

2-11     report within the first working day next following an order of the

2-12     restriction, suspension, or revocation of a physician's license or

2-13     other disciplinary action by the board against a physician to the

2-14     appropriate health care facilities and hospitals, if known by the

2-15     board.  The board shall report in writing within 30 days the

2-16     restriction, suspension, or revocation of a physician's license or

2-17     other disciplinary action by the board against a physician to the

2-18     appropriate health care facilities and hospitals, if not previously

2-19     notified in writing, professional societies of physicians in this

2-20     state, any entity responsible for the administration of Medicare

2-21     and Medicaid in this state, the U.S. Secretary of Health and Human

2-22     Services or the secretary's designee, and the complainant.  If the

2-23     board, during its review of a complaint against any physician,

2-24     discovers an act or omission potentially constituting a felony, a

2-25     misdemeanor involving moral turpitude, a violation of state or

2-26     federal narcotics or controlled substance laws, or an offense

2-27     involving fraud or abuse under the Medicare or Medicaid programs,

 3-1     the board shall report such act or omission to the appropriate

 3-2     prosecuting authority immediately except the board may exercise

 3-3     discretion in the case of impaired physicians actively

 3-4     participating in board-approved or sanctioned care, counseling, or

 3-5     treatment.

 3-6           (b)  If a physician discloses to the board in a license

 3-7     renewal application under Section 3.02(b) of this Act that the

 3-8     physician has been the subject of a disciplinary action adopted by

 3-9     a medical peer review committee, the board shall report the

3-10     information as contained in the renewal application to the Texas

3-11     Department of Health.

3-12           SECTION 3.  Sections 5.06(b), (c), and (i), Medical Practice

3-13     Act (Article 4495b, Vernon's Texas Civil Statutes), are amended to

3-14     read as follows:

3-15           (b)(1)  Each medical peer review committee or health-care

3-16     entity shall report in writing to the board the results and

3-17     circumstances of any professional review action that:

3-18                       (A)  adversely affects the clinical privileges of

3-19     a physician for a period longer than 30 days; [,]

3-20                       (B) accepts the surrender of clinical privileges

3-21     of a physician:

3-22                             (i)  while the physician is under an

3-23     investigation by the medical peer review committee relating to

3-24     possible incompetence or improper professional conduct;[,] or

3-25                             (ii)  in return for not conducting such an

3-26     investigation or proceeding;[,] or

3-27                       (C)  in the case of an entity which is a

 4-1     professional society or association, [takes a professional review

 4-2     action which] adversely affects the membership of a physician in

 4-3     the society or association.

 4-4                 (2)  The duty to report under Subsection (b)(1) of this

 4-5     section may [shall] not be nullified through contract.

 4-6                 (3)  In addition to the report made under Subsection

 4-7     (b)(1) of this section, the medical peer review committee or

 4-8     health-care entity shall file a complaint with the board under

 4-9     Section 4.02 of this Act regarding the physician.

4-10           (c)  Except as otherwise provided by this subsection, a [A]

4-11     report made under Subsection (b) of this section is  confidential

4-12     and is not subject to disclosure under the open records law.  In

4-13     any proceeding brought under this subchapter, evidence may not be

4-14     excluded on the ground of privileged communication except in the

4-15     case of communications between attorney and client.

4-16     Notwithstanding any other provision of this Act, a professional

4-17     review action that is reported to the board under Subsection (b)(1)

4-18     of this section because it adversely affects the clinical

4-19     privileges of a physician for longer than 30 days is public

4-20     information and may be disclosed as provided by the open records

4-21     law.

4-22           (i)  Disclosure of confidential peer review committee

4-23     information to the board and to the affected physician pertinent to

4-24     the matter under review does [shall] not constitute waiver of the

4-25     confidentiality provisions provided by [in] this Act.  If a medical

4-26     peer review committee takes action that could result in censure,

4-27     suspension, restriction, limitation, revocation, or denial of

 5-1     membership or privileges in a health-care entity, the medical peer

 5-2     review committee shall provide the board and the affected physician

 5-3     with [shall be provided] a written copy of the recommendation of

 5-4     the medical peer review committee and a copy of the final decision,

 5-5     including a statement of the basis for the decision.

 5-6           SECTION 4.  This Act takes effect September 1, 1997, and

 5-7     applies to an action of a medical peer review committee or

 5-8     health-care entity taken on or after that date.  An action taken

 5-9     before that date is governed by the law in effect on the date that

5-10     the action was taken, and the former law is continued in effect for

5-11     that purpose.

5-12           SECTION 5.  The importance of this legislation and the

5-13     crowded condition of the calendars in both houses create an

5-14     emergency and an imperative public necessity that the

5-15     constitutional rule requiring bills to be read on three several

5-16     days in each house be suspended, and this rule is hereby suspended.