By Zaffirini S.B. No. 1294
76R9022 MCK-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to billing medical patients.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Section 311.0025, Health and Safety Code, is
1-5 amended by amending Subsection (c) and adding Subsection (e) to
1-6 read as follows:
1-7 (c) A hospital, treatment facility, mental health facility,
1-8 or health care professional that violates Subsection (a) is subject
1-9 to disciplinary action, including denial, revocation, suspension,
1-10 or nonrenewal of the license of the hospital, facility, or
1-11 professional. The licensing agency may discipline the hospital,
1-12 facility, or professional for improperly billing a single patient
1-13 or third party payor. Disciplinary action taken under this section
1-14 is in addition to any other civil, administrative, or criminal
1-15 penalty provided by law.
1-16 (e) A licensing agency may not take disciplinary action
1-17 against a hospital, treatment facility, mental health facility, or
1-18 health care professional for unknowing and isolated billing errors.
1-19 SECTION 2. Section 5(b), Article 4512p, Revised Statutes, is
1-20 amended to read as follows:
1-21 (b) A health care professional may not violate Section
1-22 311.0025, Health and Safety Code [persistently or flagrantly
1-23 overcharge or overtreat a patient].
1-24 SECTION 3. Section 3.08, Medical Practice Act (Article
2-1 4495b, Vernon's Texas Civil Statutes), is amended to read as
2-2 follows:
2-3 Sec. 3.08. GROUNDS FOR REFUSAL TO ADMIT PERSONS TO
2-4 EXAMINATION AND TO ISSUE LICENSE AND RENEWAL LICENSE AND FOR
2-5 DISCIPLINARY ACTION. The board may refuse to admit persons to its
2-6 examinations and to issue a license to practice medicine to any
2-7 person and may take disciplinary action against any person for any
2-8 of the following reasons:
2-9 (1) submission of a false or misleading statement,
2-10 document, or certificate to the board in an application for
2-11 examination or licensure; the presentation to the board of any
2-12 license, certificate, or diploma that was illegally or fraudulently
2-13 obtained; the practice of fraud or deception in taking or passing
2-14 an examination;
2-15 (2) conviction of a crime of the grade of a felony or
2-16 a crime of a lesser degree that involves moral turpitude;
2-17 (3) intemperate use of alcohol or drugs that, in the
2-18 opinion of the board, could endanger the lives of patients;
2-19 (4) unprofessional or dishonorable conduct that is
2-20 likely to deceive or defraud the public or injure the public.
2-21 Unprofessional or dishonorable conduct likely to deceive or defraud
2-22 the public includes but is not limited to the following acts:
2-23 (A) committing any act that is in violation of
2-24 the laws of the State of Texas if the act is connected with the
2-25 physician's practice of medicine. A complaint, indictment, or
2-26 conviction of a law violation is not necessary for the enforcement
2-27 of this provision. Proof of the commission of the act while in the
3-1 practice of medicine or under the guise of the practice of medicine
3-2 is sufficient for action by the board under this section;
3-3 (B) failing to keep complete and accurate
3-4 records of purchases and disposals of drugs listed in Chapter 481,
3-5 Health and Safety Code, or of controlled substances scheduled in
3-6 the Federal Comprehensive Drug Abuse Prevention and Control Act of
3-7 1970, 21 U.S.C.A. Section 801 et seq. (Public Law 91-513). A
3-8 physician shall keep records of his purchases and disposals of
3-9 these drugs to include without limitation the date of purchase, the
3-10 sale or disposal of the drugs by the physician, the name and
3-11 address of the person receiving the drugs, and the reason for the
3-12 disposing or dispensing of the drugs to the person. A failure to
3-13 keep the records for a reasonable time is grounds for revoking,
3-14 canceling, suspending, or probating the license of any practitioner
3-15 of medicine. The board or its representative may enter and inspect
3-16 a physician's place(s) of practice during reasonable business hours
3-17 for the purpose of verifying the correctness of these records and
3-18 of taking inventory of the prescription drugs on hand;
3-19 (C) writing prescriptions for or dispensing to a
3-20 person known to be an abuser of narcotic drugs, controlled
3-21 substances, or dangerous drugs or to a person who the physician
3-22 should have known was an abuser of the narcotic drugs, controlled
3-23 substances, or dangerous drugs. This provision does not apply to
3-24 those persons:
3-25 (i) being treated by the physician for
3-26 their narcotic use after the physician notifies the board in
3-27 writing of the name and address of the person being so treated; or
4-1 (ii) who the physician is treating for
4-2 intractable pain under the Intractable Pain Treatment Act (Article
4-3 4495c, Revised Statutes) and its subsequent amendments;
4-4 (D) writing false or fictitious prescriptions
4-5 for dangerous drugs as defined by Chapter 483, Health and Safety
4-6 Code, of controlled substances scheduled in the Texas Controlled
4-7 Substances Act (Chapter 481, Health and Safety Code), or of
4-8 controlled substances scheduled in the Federal Comprehensive Drug
4-9 Abuse Prevention and Control Act of 1970, 21 U.S.C.A. Section 801
4-10 et seq. (Public Law 91-513);
4-11 (E) prescribing or administering a drug or
4-12 treatment that is nontherapeutic in nature or nontherapeutic in the
4-13 manner the drug or treatment is administered or prescribed;
4-14 (F) prescribing, administering, or dispensing in
4-15 a manner not consistent with public health and welfare dangerous
4-16 drugs as defined by Chapter 483, Health and Safety Code, controlled
4-17 substances scheduled in the Texas Controlled Substances Act
4-18 (Chapter 481, Health and Safety Code), or controlled substances
4-19 scheduled in the Federal Comprehensive Drug Abuse Prevention and
4-20 Control Act of 1970, 21 U.S.C.A. Section 801 et seq. (Public Law
4-21 91-513);
4-22 (G) violating Section 311.0025, Health and
4-23 Safety Code, or any other state or federal law or rule related to
4-24 billing [persistently or flagrantly overcharging or overtreating
4-25 patients];
4-26 (H) failing to supervise adequately the
4-27 activities of those acting under the supervision of the physician;
5-1 or
5-2 (I) delegating professional medical
5-3 responsibility or acts to a person if the delegating physician
5-4 knows or has reason to know that the person is not qualified by
5-5 training, experience, or licensure to perform the responsibility or
5-6 acts;
5-7 (5) violation or attempted violation, direct or
5-8 indirect, of any valid rules issued under this Act, either as a
5-9 principal, accessory, or accomplice;
5-10 (6) use of any advertising statement that is false,
5-11 misleading, or deceptive;
5-12 (7) advertising professional superiority or the
5-13 performance of professional service in a superior manner if the
5-14 advertising is not readily subject to verification;
5-15 (8) purchase, sale, barter, or use or any offer to
5-16 purchase, sell, barter, or use any medical degree, license,
5-17 certificate, diploma, or transcript of license, certificate, or
5-18 diploma in or incident to an application to the board for a license
5-19 to practice medicine;
5-20 (9) altering, with fraudulent intent, any medical
5-21 license, certificate, diploma, or transcript of a medical license,
5-22 certificate, or diploma;
5-23 (10) using any medical license, certificate, diploma,
5-24 or transcript of a medical license, certificate, or diploma that
5-25 has been fraudulently purchased, issued, or counterfeited or that
5-26 has been materially altered;
5-27 (11) impersonating or acting as proxy for another in
6-1 any examination required by this Act for a medical license; or
6-2 engaging in conduct which subverts or attempts to subvert any
6-3 examination process required by this Act for a medical license.
6-4 Conduct which subverts or attempts to subvert the medical licensing
6-5 examination process includes, but is not limited to:
6-6 (A) conduct which violates the security of the
6-7 examination materials, as prescribed by board rules;
6-8 (B) conduct which violates the standard of test
6-9 administration, as prescribed by board rules; or
6-10 (C) conduct which violates the accreditation
6-11 process, as prescribed by board rules;
6-12 (12) impersonating a licensed practitioner or
6-13 permitting or allowing another to use his license or certificate to
6-14 practice medicine in this state for the purpose of diagnosing,
6-15 treating, or offering to treat sick, injured, or afflicted human
6-16 beings;
6-17 (13) employing, directly or indirectly, any person
6-18 whose license to practice medicine has been suspended, canceled, or
6-19 revoked or association in the practice of medicine with any person
6-20 or persons whose license to practice medicine has been suspended,
6-21 canceled, or revoked or any person who has been convicted of the
6-22 unlawful practice of medicine in Texas or elsewhere;
6-23 (14) performing or procuring a criminal abortion or
6-24 aiding or abetting in the procuring of a criminal abortion or
6-25 attempting to perform or procure a criminal abortion or attempting
6-26 to aid or abet the performance or procurement of a criminal
6-27 abortion;
7-1 (15) aiding or abetting, directly or indirectly, the
7-2 practice of medicine by any person, partnership, association, or
7-3 corporation not duly licensed to practice medicine by the board;
7-4 (16) inability to practice medicine with reasonable
7-5 skill and safety to patients by reason of illness, drunkenness,
7-6 excessive use of drugs, narcotics, chemicals, or any other type of
7-7 material or as a result of any mental or physical condition. In
7-8 enforcing this subdivision the board shall, upon probable cause,
7-9 request a physician to submit to a mental or physical examination
7-10 by physicians designated by the board. If the physician refuses to
7-11 submit to the examination, the board shall issue an order requiring
7-12 the physician to show cause why he should not be required to submit
7-13 to the examination and shall schedule a hearing on the order within
7-14 30 days after notice is served on the physician. The physician
7-15 shall be notified by either personal service or certified mail with
7-16 return receipt requested. At the hearing, the physician and his
7-17 attorney are entitled to present any testimony and other evidence
7-18 to show why the physician should not be required to submit to the
7-19 examination. After a complete hearing, the board shall issue an
7-20 order either requiring the physician to submit to the examination
7-21 or withdrawing the request for examination. An appeal from the
7-22 decision of the board shall be taken under the Administrative
7-23 Procedure Act;
7-24 (17) judgment by a court of competent jurisdiction
7-25 that a person licensed to practice medicine is of unsound mind;
7-26 (18) professional failure to practice medicine in an
7-27 acceptable manner consistent with public health and welfare;
8-1 (19) being removed, suspended, or having disciplinary
8-2 action taken by his peers in any professional medical association
8-3 or society, whether the association or society is local, regional,
8-4 state, or national in scope, or being disciplined by a licensed
8-5 hospital or medical staff of a hospital, including removal,
8-6 suspension, limitation of hospital privileges, or other
8-7 disciplinary action, if that action in the opinion of the board was
8-8 based on unprofessional conduct or professional incompetence that
8-9 was likely to harm the public, provided that the board finds that
8-10 the actions were appropriate and reasonably supported by evidence
8-11 submitted to it. The action does not constitute state action on
8-12 the part of the association, society, or hospital medical staff;
8-13 (20) repeated or recurring meritorious health-care
8-14 liability claims that in the opinion of the board evidence
8-15 professional incompetence likely to injure the public; or
8-16 (21) suspension, revocation, restriction, or other
8-17 disciplinary action by another state of a license to practice
8-18 medicine, or disciplinary action by the uniformed services of the
8-19 United States, based upon acts by the licensee similar to acts
8-20 described in this section. A certified copy of the record of the
8-21 state taking the action is conclusive evidence of it.
8-22 SECTION 4. This Act takes effect September 1, 1999, and
8-23 applies only to acts or omissions occurring on or after that date.
8-24 SECTION 5. The importance of this legislation and the
8-25 crowded condition of the calendars in both houses create an
8-26 emergency and an imperative public necessity that the
8-27 constitutional rule requiring bills to be read on three several
9-1 days in each house be suspended, and this rule is hereby suspended.