1-1 By: Zaffirini S.B. No. 1294
1-2 (In the Senate - Filed March 11, 1999; March 15, 1999, read
1-3 first time and referred to Committee on Health Services;
1-4 April 15, 1999, reported adversely, with favorable Committee
1-5 Substitute by the following vote: Yeas 5, Nays 0; April 15, 1999,
1-6 sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR S.B. No. 1294 By: Nelson
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to billing medical patients.
1-11 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-12 SECTION 1. Section 311.0025, Health and Safety Code, is
1-13 amended by adding Subsection (e) to read as follows:
1-14 (e) A licensing agency may not take disciplinary action
1-15 against a hospital, treatment facility, mental health facility, or
1-16 health care professional for unknowing and isolated billing errors.
1-17 SECTION 2. Subsection (b), Section 5, Article 4512p, Revised
1-18 Statutes, is amended to read as follows:
1-19 (b) A health care professional may not violate Section
1-20 311.0025, Health and Safety Code [persistently or flagrantly
1-21 overcharge or overtreat a patient].
1-22 SECTION 3. Section 3.08, Medical Practice Act (Article
1-23 4495b, Vernon's Texas Civil Statutes), is amended to read as
1-24 follows:
1-25 Sec. 3.08. GROUNDS FOR REFUSAL TO ADMIT PERSONS TO
1-26 EXAMINATION AND TO ISSUE LICENSE AND RENEWAL LICENSE AND FOR
1-27 DISCIPLINARY ACTION. The board may refuse to admit persons to its
1-28 examinations and to issue a license to practice medicine to any
1-29 person and may take disciplinary action against any person for any
1-30 of the following reasons:
1-31 (1) submission of a false or misleading statement,
1-32 document, or certificate to the board in an application for
1-33 examination or licensure; the presentation to the board of any
1-34 license, certificate, or diploma that was illegally or fraudulently
1-35 obtained; the practice of fraud or deception in taking or passing
1-36 an examination;
1-37 (2) conviction of a crime of the grade of a felony or
1-38 a crime of a lesser degree that involves moral turpitude;
1-39 (3) intemperate use of alcohol or drugs that, in the
1-40 opinion of the board, could endanger the lives of patients;
1-41 (4) unprofessional or dishonorable conduct that is
1-42 likely to deceive or defraud the public or injure the public.
1-43 Unprofessional or dishonorable conduct likely to deceive or defraud
1-44 the public includes but is not limited to the following acts:
1-45 (A) committing any act that is in violation of
1-46 the laws of the State of Texas if the act is connected with the
1-47 physician's practice of medicine. A complaint, indictment, or
1-48 conviction of a law violation is not necessary for the enforcement
1-49 of this provision. Proof of the commission of the act while in the
1-50 practice of medicine or under the guise of the practice of medicine
1-51 is sufficient for action by the board under this section;
1-52 (B) failing to keep complete and accurate
1-53 records of purchases and disposals of drugs listed in Chapter 481,
1-54 Health and Safety Code, or of controlled substances scheduled in
1-55 the Federal Comprehensive Drug Abuse Prevention and Control Act of
1-56 1970, 21 U.S.C.A. Section 801 et seq. (Public Law 91-513). A
1-57 physician shall keep records of his purchases and disposals of
1-58 these drugs to include without limitation the date of purchase, the
1-59 sale or disposal of the drugs by the physician, the name and
1-60 address of the person receiving the drugs, and the reason for the
1-61 disposing or dispensing of the drugs to the person. A failure to
1-62 keep the records for a reasonable time is grounds for revoking,
1-63 canceling, suspending, or probating the license of any practitioner
1-64 of medicine. The board or its representative may enter and inspect
2-1 a physician's place(s) of practice during reasonable business hours
2-2 for the purpose of verifying the correctness of these records and
2-3 of taking inventory of the prescription drugs on hand;
2-4 (C) writing prescriptions for or dispensing to a
2-5 person known to be an abuser of narcotic drugs, controlled
2-6 substances, or dangerous drugs or to a person who the physician
2-7 should have known was an abuser of the narcotic drugs, controlled
2-8 substances, or dangerous drugs. This provision does not apply to
2-9 those persons:
2-10 (i) being treated by the physician for
2-11 their narcotic use after the physician notifies the board in
2-12 writing of the name and address of the person being so treated; or
2-13 (ii) who the physician is treating for
2-14 intractable pain under the Intractable Pain Treatment Act (Article
2-15 4495c, Revised Statutes) and its subsequent amendments;
2-16 (D) writing false or fictitious prescriptions
2-17 for dangerous drugs as defined by Chapter 483, Health and Safety
2-18 Code, of controlled substances scheduled in the Texas Controlled
2-19 Substances Act (Chapter 481, Health and Safety Code), or of
2-20 controlled substances scheduled in the Federal Comprehensive Drug
2-21 Abuse Prevention and Control Act of 1970, 21 U.S.C.A. Section 801
2-22 et seq. (Public Law 91-513);
2-23 (E) prescribing or administering a drug or
2-24 treatment that is nontherapeutic in nature or nontherapeutic in the
2-25 manner the drug or treatment is administered or prescribed;
2-26 (F) prescribing, administering, or dispensing in
2-27 a manner not consistent with public health and welfare dangerous
2-28 drugs as defined by Chapter 483, Health and Safety Code, controlled
2-29 substances scheduled in the Texas Controlled Substances Act
2-30 (Chapter 481, Health and Safety Code), or controlled substances
2-31 scheduled in the Federal Comprehensive Drug Abuse Prevention and
2-32 Control Act of 1970, 21 U.S.C.A. Section 801 et seq. (Public Law
2-33 91-513);
2-34 (G) violating Section 311.0025, Health and
2-35 Safety Code [persistently or flagrantly overcharging or
2-36 overtreating patients];
2-37 (H) failing to supervise adequately the
2-38 activities of those acting under the supervision of the physician;
2-39 or
2-40 (I) delegating professional medical
2-41 responsibility or acts to a person if the delegating physician
2-42 knows or has reason to know that the person is not qualified by
2-43 training, experience, or licensure to perform the responsibility or
2-44 acts;
2-45 (5) violation or attempted violation, direct or
2-46 indirect, of any valid rules issued under this Act, either as a
2-47 principal, accessory, or accomplice;
2-48 (6) use of any advertising statement that is false,
2-49 misleading, or deceptive;
2-50 (7) advertising professional superiority or the
2-51 performance of professional service in a superior manner if the
2-52 advertising is not readily subject to verification;
2-53 (8) purchase, sale, barter, or use or any offer to
2-54 purchase, sell, barter, or use any medical degree, license,
2-55 certificate, diploma, or transcript of license, certificate, or
2-56 diploma in or incident to an application to the board for a license
2-57 to practice medicine;
2-58 (9) altering, with fraudulent intent, any medical
2-59 license, certificate, diploma, or transcript of a medical license,
2-60 certificate, or diploma;
2-61 (10) using any medical license, certificate, diploma,
2-62 or transcript of a medical license, certificate, or diploma that
2-63 has been fraudulently purchased, issued, or counterfeited or that
2-64 has been materially altered;
2-65 (11) impersonating or acting as proxy for another in
2-66 any examination required by this Act for a medical license; or
2-67 engaging in conduct which subverts or attempts to subvert any
2-68 examination process required by this Act for a medical license.
2-69 Conduct which subverts or attempts to subvert the medical licensing
3-1 examination process includes, but is not limited to:
3-2 (A) conduct which violates the security of the
3-3 examination materials, as prescribed by board rules;
3-4 (B) conduct which violates the standard of test
3-5 administration, as prescribed by board rules; or
3-6 (C) conduct which violates the accreditation
3-7 process, as prescribed by board rules;
3-8 (12) impersonating a licensed practitioner or
3-9 permitting or allowing another to use his license or certificate to
3-10 practice medicine in this state for the purpose of diagnosing,
3-11 treating, or offering to treat sick, injured, or afflicted human
3-12 beings;
3-13 (13) employing, directly or indirectly, any person
3-14 whose license to practice medicine has been suspended, canceled, or
3-15 revoked or association in the practice of medicine with any person
3-16 or persons whose license to practice medicine has been suspended,
3-17 canceled, or revoked or any person who has been convicted of the
3-18 unlawful practice of medicine in Texas or elsewhere;
3-19 (14) performing or procuring a criminal abortion or
3-20 aiding or abetting in the procuring of a criminal abortion or
3-21 attempting to perform or procure a criminal abortion or attempting
3-22 to aid or abet the performance or procurement of a criminal
3-23 abortion;
3-24 (15) aiding or abetting, directly or indirectly, the
3-25 practice of medicine by any person, partnership, association, or
3-26 corporation not duly licensed to practice medicine by the board;
3-27 (16) inability to practice medicine with reasonable
3-28 skill and safety to patients by reason of illness, drunkenness,
3-29 excessive use of drugs, narcotics, chemicals, or any other type of
3-30 material or as a result of any mental or physical condition. In
3-31 enforcing this subdivision the board shall, upon probable cause,
3-32 request a physician to submit to a mental or physical examination
3-33 by physicians designated by the board. If the physician refuses to
3-34 submit to the examination, the board shall issue an order requiring
3-35 the physician to show cause why he should not be required to submit
3-36 to the examination and shall schedule a hearing on the order within
3-37 30 days after notice is served on the physician. The physician
3-38 shall be notified by either personal service or certified mail with
3-39 return receipt requested. At the hearing, the physician and his
3-40 attorney are entitled to present any testimony and other evidence
3-41 to show why the physician should not be required to submit to the
3-42 examination. After a complete hearing, the board shall issue an
3-43 order either requiring the physician to submit to the examination
3-44 or withdrawing the request for examination. An appeal from the
3-45 decision of the board shall be taken under the Administrative
3-46 Procedure Act;
3-47 (17) judgment by a court of competent jurisdiction
3-48 that a person licensed to practice medicine is of unsound mind;
3-49 (18) professional failure to practice medicine in an
3-50 acceptable manner consistent with public health and welfare;
3-51 (19) being removed, suspended, or having disciplinary
3-52 action taken by his peers in any professional medical association
3-53 or society, whether the association or society is local, regional,
3-54 state, or national in scope, or being disciplined by a licensed
3-55 hospital or medical staff of a hospital, including removal,
3-56 suspension, limitation of hospital privileges, or other
3-57 disciplinary action, if that action in the opinion of the board was
3-58 based on unprofessional conduct or professional incompetence that
3-59 was likely to harm the public, provided that the board finds that
3-60 the actions were appropriate and reasonably supported by evidence
3-61 submitted to it. The action does not constitute state action on
3-62 the part of the association, society, or hospital medical staff;
3-63 (20) repeated or recurring meritorious health-care
3-64 liability claims that in the opinion of the board evidence
3-65 professional incompetence likely to injure the public; or
3-66 (21) suspension, revocation, restriction, or other
3-67 disciplinary action by another state of a license to practice
3-68 medicine, or disciplinary action by the uniformed services of the
3-69 United States, based upon acts by the licensee similar to acts
4-1 described in this section. A certified copy of the record of the
4-2 state taking the action is conclusive evidence of it.
4-3 SECTION 4. This Act takes effect September 1, 1999, and
4-4 applies only to acts or omissions occurring on or after that date.
4-5 SECTION 5. The importance of this legislation and the
4-6 crowded condition of the calendars in both houses create an
4-7 emergency and an imperative public necessity that the
4-8 constitutional rule requiring bills to be read on three several
4-9 days in each house be suspended, and this rule is hereby suspended.
4-10 * * * * *