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79R6801 JMM-F

By:  Armbrister                                                   S.B. No. 762



A BILL TO BE ENTITLED

AN ACT

relating to certain unprofessional conduct by a health care 
provider; providing an administrative penalty.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Section 105.001, Occupations Code, is amended to 
read as follows:
	Sec. 105.001.  DEFINITION.  In this chapter, "health care 
provider" means a person who furnishes services under a license, 
certificate, registration, or other authority issued by this state 
or another state to diagnose, prevent, alleviate, or cure a human 
illness or injury.  The term includes a hospital licensed under 
Chapter 241, Health and Safety Code.
	SECTION 2.  Section 105.002, Occupations Code, is amended to 
read as follows:
	Sec. 105.002.  UNPROFESSIONAL CONDUCT.  (a)  A health care 
provider commits unprofessional conduct if the health care 
provider, in connection with the provider's professional 
activities:
		(1)  knowingly presents or causes to be presented a 
false or fraudulent claim for the payment of a loss under an 
insurance policy; [or]
		(2)  knowingly prepares, makes, or subscribes to any 
writing, with intent to present or use the writing, or to allow it 
to be presented or used, in support of a false or fraudulent claim 
under an insurance policy;
		(3)  collects or attempts to collect a payment from a 
person knowing that the collection or attempt to collect violates a 
contract, agreement, or other arrangement between the health care 
provider and the person's insurer, health maintenance 
organization, preferred provider organization, or other health 
care payor; or
		(4)  knowingly charges a person or the person's 
insurer, health maintenance organization, preferred provider 
organization, or other health care payor for diagnostic testing 
unless the health care provider rendered a professional service in 
the direct care and treatment of the person in relation to the 
diagnostic test.
	(b)  In addition to other provisions of civil or criminal 
law, commission of unprofessional conduct under Subsection (a) 
constitutes cause for:
		(1)  the revocation or suspension of a provider's 
license, permit, registration, certificate, or other authority or 
other disciplinary action; and
		(2)  imposition of an administrative penalty of $500 
for each violation of this chapter or a greater amount determined by 
the entity authorized by law to impose the penalty.
	SECTION 3.  The change in law made by this Act applies only 
to conduct that occurs on or after the effective date of this Act.  
Conduct that occurs before that date is governed by the law in 
effect at the time the conduct occurred, and the former law is 
continued in effect for that purpose.
	SECTION 4.  This Act takes effect September 1, 2005.