2003S0521-1 03/06/03
By: Armbrister S.B. No. 1266
A BILL TO BE ENTITLED
AN ACT
relating to the regulation of certain health care benefits and
services, including practice of acupuncture.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subsection (B), Section 2, Chapter 397, Acts of
the 54th Legislature, Regular Session, 1955, (Article 3.70-2,
Vernon's Texas Insurance Code), is amended to read as follows:
(B) No policy of accident and sickness insurance shall make
benefits contingent upon treatment or examination by a particular
practitioner or by particular practitioners of the healing arts
[hereinafter designated unless such policy contains a provision
designating the practitioner or practitioners who will be
recognized by the insurer and those who will not be recognized by
the insurer. Such provision may be located in the "Exceptions" or
"Exceptions and Reductions" provisions, or elsewhere in the policy,
or by endorsement attached to the policy, at the insurer's option.
In designating the practitioners who will and will not be
recognized, such provision shall use the following terms: Doctor
of Medicine, Doctor of Osteopathy, Doctor of Dentistry, Doctor of
Chiropractic, Doctor of Optometry, Doctor of Podiatry, Licensed
Audiologist, Licensed Speech-language Pathologist, Doctor in
Psychology, Licensed Master Social Worker--Advanced Clinical
Practitioner, Licensed Dietitian, Licensed Professional Counselor,
Licensed Marriage and Family Therapist, Licensed Chemical
Dependency Counselor, Licensed Hearing Instrument Fitter and
Dispenser, Advanced Practice Nurse, Physician Assistant, Licensed
Occupational Therapist, Licensed Physical Therapist, Licensed
Acupuncturist, Licensed Psychological Associate, and Licensed
Surgical Assistant.
[For purposes of this Act, such designations shall have the
following meanings:
[Doctor of Medicine: One licensed by the Texas State Board of
Medical Examiners on the basis of the degree "Doctor of Medicine";
[Doctor of Osteopathy: One licensed by the Texas State Board
of Medical Examiners on the basis of the degree of "Doctor of
Osteopathy";
[Doctor of Dentistry: One licensed by the State Board of
Dental Examiners;
[Doctor of Chiropractic: One licensed by the Texas Board of
Chiropractic Examiners;
[Doctor of Optometry: One licensed by the Texas Optometry
Board;
[Doctor of Podiatry: One licensed by the Texas State Board of
Podiatric Medical Examiners;
[Licensed Audiologist: One with a master's or doctorate
degree in audiology from an accredited college or university and
who is licensed as an audiologist by the State Board of Examiners
for Speech-Language Pathology and Audiology;
[Licensed Speech-language Pathologist: One with a master's
or doctorate degree in speech pathology or speech-language
pathology from an accredited college or university and who is
licensed as a speech-language pathologist by the State Board of
Examiners for Speech-Language Pathology and Audiology;
[Doctor in Psychology: One licensed by the Texas State Board
of Examiners of Psychologists and certified as a Health Service
Provider;
[Licensed Master Social Worker--Advanced Clinical
Practitioner: One licensed by the Texas State Board of Social
Worker Examiners as a Licensed Master Social Worker with the order
of recognition of Advanced Clinical Practitioner;
[Licensed Dietitian: One licensed by the Texas State Board
of Examiners of Dietitians;
[Licensed Professional Counselor: One licensed by the Texas
State Board of Examiners of Professional Counselors;
[Licensed Marriage and Family Therapist: One licensed by the
Texas State Board of Examiners of Marriage and Family Therapists;
[Licensed Chemical Dependency Counselor: One licensed by the
Texas Commission on Alcohol and Drug Abuse;
[Licensed Hearing Instrument Fitter and Dispenser: One
licensed by the State Committee of Examiners in the Fitting and
Dispensing of Hearing Instruments;
[Advanced Practice Nurse: One licensed by the Board of Nurse
Examiners as a registered nurse and recognized by that board as an
advanced practice nurse;
[Physician Assistant: One licensed by the Texas State Board
of Physician Assistant Examiners;
[Licensed Occupational Therapist: One licensed by the Texas
Board of Occupational Therapy Examiners;
[Licensed Physical Therapist: One licensed by the Texas
Board of Physical Therapy Examiners;
[Licensed Acupuncturist: One licensed by the Texas State
Board of Medical Examiners as an acupuncturist;
[Licensed Psychological Associate: One licensed by the Texas
State Board of Examiners of Psychologists and practicing under the
supervision of a licensed psychologist; and
[Licensed Surgical Assistant: One licensed by the Texas
State Board of Medical Examiners as a surgical assistant].
SECTION 2. Subdivision (9), Section 1, Article 3.70-3C,
Insurance Code, as added by Chapter 1024, Acts of the 75th
Legislature, Regular Session, 1997, is amended to read as follows:
(9) "Practitioner" means a person who practices a
healing art including a:
(A) doctor of medicine;
(B) doctor of osteopathy;
(C) doctor of dentistry;
(D) doctor of chiropractic;
(E) doctor of optometry;
(F) doctor of podiatry;
(G) licensed audiologist;
(H) licensed speech-language pathologist;
(I) doctor in psychology;
(J) licensed master social worker--advanced
clinical practitioner;
(K) licensed dietitian;
(L) licensed professional counselor;
(M) licensed marriage and family therapist;
(N) licensed chemical dependency counselor;
(O) licensed hearing instrument fitter and
dispenser;
(P) advanced practice nurse;
(Q) physician assistant;
(R) licensed occupational therapist;
(S) licensed physical therapist;
(T) licensed acupuncturist;
(U) licensed psychological associate;
(V) licensed surgical assistant; or
(W) person listed in [and is a practitioner
described by:
[(A) Section 2(B), Chapter 397, Acts of the 54th
Legislature, 1955 (Article 3.70-2, Vernon's Texas Insurance Code);
or
[(B)] Article 21.52 of this code.
SECTION 3. Subdivision (3), Subsection (a), Article 21.52C,
Insurance Code, is amended to read as follows:
(3) "Provider" means a person who provides health care
under a license issued by this state, including a:
(A) doctor of medicine;
(B) doctor of osteopathy;
(C) doctor of dentistry;
(D) doctor of chiropractic;
(E) doctor of optometry;
(F) doctor of podiatry;
(G) licensed audiologist;
(H) licensed speech-language pathologist;
(I) doctor in psychology;
(J) licensed master social worker--advanced
clinical practitioner;
(K) licensed dietitian;
(L) licensed professional counselor;
(M) licensed marriage and family therapist;
(N) licensed chemical dependency counselor;
(O) licensed hearing instrument fitter and
dispenser;
(P) advanced practice nurse;
(Q) physician assistant;
(R) licensed occupational therapist;
(S) licensed physical therapist;
(T) licensed acupuncturist;
(U) licensed psychological associate;
(V) licensed surgical assistant; or
(W) person listed in [Section 2(B), Chapter 397,
Acts of the 54th Legislature, Regular Session, 1955 (Article
3.70-2, Vernon's Texas Insurance Code), or in] Article 21.52 of
this code.
SECTION 4. Subsection (c), Section 843.304, the Insurance
Code, as effective June 1, 2003, is amended to read as follows:
(c) This section does not require that a health maintenance
organization:
(1) [use a particular type of provider in its
operation;
[(2)] accept each provider of a category or type,
except as provided by Article 21.52B; or
(2) [(3)] contract directly with providers of a
particular category or type.
SECTION 5. Subdivision (2), Section 205.001, Occupations
Code, is amended to read as follows:
(2) "Acupuncture" means:
(A) the nonsurgical, nonincisive insertion of an
acupuncture needle and the application of moxibustion to specific
areas of the human body as a primary mode of therapy to treat and
mitigate a human condition, including evaluation and assessment of
the condition; and
(B) the administration or recommendation of
thermal or electrical treatments, herbal and dietary formulas and
supplements, and energy flow exercises, including acupressure,
tuina, shiatsu, and other forms of Asian bodywork, and [or] the
recommendation of dietary guidelines, [energy flow exercise, or
dietary or herbal supplements] in conjunction with the treatment
described by Paragraph (A).
SECTION 6. Section 205.101, Occupations Code, is amended to
read as follows:
Sec. 205.101. GENERAL POWERS AND DUTIES OF ACUPUNCTURE
BOARD. (a) Subject to the advice and approval of the medical
board, the acupuncture board shall:
(1) establish qualifications for an acupuncturist to
practice in this state;
(2) [establish minimum education and training
requirements necessary for the acupuncture board to recommend that
the medical board issue a license to practice acupuncture;
[(3)] administer an examination that is validated by
independent testing professionals for a license to practice
acupuncture;
(3) [(4)] develop requirements for licensure by
endorsement of other states;
(4) [(5)] prescribe the application form for a license
to practice acupuncture;
(5) [(6)] make recommendations on applications for
licenses to practice acupuncture; and
(6) [(7) establish the requirements for a tutorial
program for acupuncture students who have completed at least 48
semester hours of college; and
[(8)] recommend additional rules as are necessary to
administer and enforce this chapter.
(b) The acupuncture board shall establish minimum
educational and training requirements as necessary to enable the
acupuncture board to recommend that the medical board issue a
license to practice acupuncture. In establishing the requirements,
the acupuncture board may consider the minimum educational and
training requirements established by the Accreditation Commission
for Acupuncture and Oriental Medicine [does not have independent
rulemaking authority].
SECTION 7. The section heading and Subsections (a) and (c),
Section 205.301, Occupations Code, is amended to read as follows:
Sec. 205.301. EVALUATION [REFERRAL] BY OTHER HEALTH CARE
PRACTITIONER REQUIRED. (a) A license holder may perform
acupuncture on a person only if the person was:
(1) evaluated by a physician or dentist, as
appropriate, for the condition being treated within six months
before the date acupuncture is performed; or
(2) evaluated [referred] by a chiropractor within 30
days before the date acupuncture is performed.
(c) A license holder acting under Subsection (a)(2) shall
refer the person to a physician after performing acupuncture 20
times or for 30 days, whichever occurs first, if substantial
improvement does not occur in the person's condition for which the
evaluation [referral] was made.
SECTION 8. Section 205.302, Occupations Code, is amended to
read as follows:
Sec. 205.302. AUTHORIZED PRACTICE WITHOUT EVALUATION
[REFERRAL]. (a) After notice and public hearing, the medical
board shall determine by rule whether an acupuncturist may treat a
patient for stress, allergies, nausea and digestive disorders,
depression, insomnia, and cosmetic procedures [alcoholism or
chronic pain] without an evaluation [a referral] from a physician,
dentist, or chiropractor. The medical board shall make the
determination based on clinical evidence and what the medical board
determines to be in the best interest of affected patients.
(b) Notwithstanding Section 205.301, a license holder may,
without an evaluation [a referral] from a physician, dentist, or
chiropractor, perform acupuncture on a person for:
(1) smoking addiction;
(2) weight loss; [or]
(3) substance abuse;
(4) alcoholism; or
(5) chronic pain[, to the extent permitted by medical
board rule adopted with advice from the acupuncture board].
SECTION 9. Section 205.355, Occupations Code, is amended to
read as follows:
Sec. 205.355. REQUIRED DISCIPLINARY ACTION FOR FAILURE TO
OBTAIN EVALUATION [REFERRAL]. Except as provided by Section
205.301(a)(2), a license to practice acupuncture shall be denied
or, after notice and hearing, revoked if the applicant or license
holder violates Section 205.301(a)(1).
SECTION 10. This Act takes effect September 1, 2003.