SRC-VRA H.B. 2131 78(R)   BILL ANALYSIS


Senate Research Center   H.B. 2131
78R12231 MXM-DBy: Zedler (Deuell)
Health & Human Services
5/10/2003
Engrossed


DIGEST AND PURPOSE 

The 77th Legislature amended the Nursing Practice Act  by adding section
301.1525.  The Board of Nurse Practitioners was authorized to develop and
enact rules governing Registered Nurse First Assistant (RNFA) practice.
It was the  understanding of some nurses  that the Nursing Practice Act
was amended to allow for reimbursement of those functioning in the
capacity as an RNFA.  The wording of the legislation provided a definition
of a nurse first assistant that was not limited only to those seeking
reimbursement.  As a result there are some nurses that will be ineligible
to continue preforming the  duties  they have preformed for several years,
unless they complete the training and other requirements to become an
RNFA. 

The legislation established a limit by which time nurses had to complete
training to become an RNFA or stop functioning in that role.  Some nurses
employed by doctors, hospitals, or physicians group who have been
assisting doctors in the operating room for many years do not want to be
reimbursed for the duties they perform and therefore do not want to go
through the process to become an RNFA.  H.B. 2131 adds a new provision to
the Occupations Code relating to the regulation of certain operating room
nurses employed by other health providers. 


RULEMAKING AUTHORITY

This bill does not expressly grant any additional rulemaking authority to
a state officer, department, agency, or institution.  

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Subchapter D, Chapter 301, Occupations Code, by adding
Sections 301.1526 and 301.1527, as follows: 

Sec. 301.1526.  CERTAIN NURSES DIRECTLY ASSISTING IN SURGERY.  (a)
Provides that this section does not apply to a registered nurse who is a
nurse first assistant under Section 301.1525. 
 
(b)  Authorizes a  registered nurse to whom this section applies to
directly assist a physician, physician's group, podiatrist, or dentist to
perform surgery if the nurse meets certain criteria. 
 
 (c)  Defines "directly assisting in surgery."
 
(d)  Prohibits a registered nurse, physician, physician's group,
podiatrist, or dentist, or the facility at which surgery is performed
under this section, from separately billing the services of the registered
nurse to the patient or to any thirdparty insurer. 
 
(e)  Prohibits a registered nurse to whom this section applies from using
certain titles. 
 
 (f)  Provides that this section expires January 1, 2007.
 
 Sec. 301.1527.  CERTAIN NURSES DIRECTLY ASSISTING IN SURGERY IN SMALL
HOSPITALS.  (a)  Defines "small hospital." 

(b)  Provides that this section does not apply to a registered nurse who
is a nurse first assistant under Section 301.1525. 
 
(c)  Authorizes a registered nurse to whom this section applies to
directly assist a physician, physician's group, podiatrist, or dentist to
perform surgery at a small hospital if the nurse meets certain criteria. 
  
 (d)  Defines "directly assisting in surgery."
  
(e)  Prohibits a registered nurse, physician, physician's group,
podiatrist, or dentist, or the facility at which surgery is performed
under this section, from separately billing the services of the registered
nurse to the patient or to any thirdparty insurer. 
 
(f)  Prohibits a registered nurse to whom this section applies from using
certain titles. 
  
SECTION 2.  (a)  Provides that except as provided by Subsection (b) of
this section, this Act takes effect September 1, 2003. 

(b)  Provides that Section 301.1527, Occupations Code, as added by this
Act, takes effect January 1, 2007.