By: Williams, et al. S.B. No. 911
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the certification and regulation of pain management
  clinics.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subtitle B, Title 3, Occupations Code, is
  amended by adding Chapter 167 to read as follows:
  CHAPTER 167. REGULATION OF PAIN MANAGEMENT CLINICS
  SUBCHAPTER A. GENERAL PROVISIONS
         Sec. 167.001.  DEFINITION. In this chapter, "pain
  management clinic" means a publicly or privately owned facility for
  which a majority of patients are issued on a monthly basis a
  prescription for opioids, benzodiazepines, barbiturates, or
  carisoprodol, but not including suboxone.
         Sec. 167.002.  EXEMPTIONS. This chapter does not apply to:
               (1)  a medical or dental school or an outpatient clinic
  associated with a medical or dental school;
               (2)  a hospital, including any outpatient facility or
  clinic of a hospital;
               (3)  a hospice established under 40 T.A.C. Section
  97.403 or defined by 42 C.F.R. Section 418.3;
               (4)  a facility maintained or operated by this state;
               (5)  a clinic maintained or operated by the United
  States;
               (6)  a health organization certified by the board under
  Section 162.001; or
               (7)  a clinic owned or operated by a physician who
  treats patients within the physician's area of specialty and who
  uses other forms of treatment, including surgery, with the issuance
  of a prescription for a majority of the patients.
  [Sections 167.003-167.050 reserved for expansion]
  SUBCHAPTER B. POWERS AND DUTIES OF BOARD
         Sec. 167.051.  ADOPTION OF RULES. The board shall adopt
  rules necessary to implement this chapter, including rules to
  address, for a pain management clinic:
               (1)  the operation of the clinic;
               (2)  personnel requirements for the clinic, including
  requirements for a physician who practices at a clinic;
               (3)  standards to ensure quality of patient care;
               (4)  certificate application and renewal procedures
  and requirements;
               (5)  inspections and complaint investigations; and
               (6)  patient billing procedures.
         Sec. 167.052.  INSPECTIONS. The board may inspect a pain
  management clinic, including the documents of a physician
  practicing at the clinic, as necessary to ensure compliance with
  this chapter.
         Sec. 167.053.  COMPLAINTS. The board shall investigate a
  complaint alleging a violation of this chapter or a rule adopted
  under this chapter by a pain management clinic certified under this
  chapter or a physician who owns or operates a clinic in the same
  manner as other complaints under this subtitle.
  [Sections 167.054-167.100 reserved for expansion]
  SUBCHAPTER C. CERTIFICATION OF CLINIC
         Sec. 167.101.  CERTIFICATE REQUIRED. (a)  A pain management
  clinic may not operate in this state unless the clinic is certified
  under this chapter.
         (b)  A certificate issued under this chapter is not
  transferable or assignable.
         Sec. 167.102.  CERTIFICATE APPLICATION AND ISSUANCE. (a)  A
  physician who owns or operates a pain management clinic shall apply
  for a certificate for the clinic under this chapter. A pain
  management clinic must be owned and operated by a medical director
  who is a physician who practices in this state under an unrestricted
  license.
         (b)  An applicant for a certificate under this chapter must
  submit an application to the board on a form prescribed by the
  board.
         (c)  The board shall issue a certificate if the board finds
  that the pain management clinic meets the requirements of this
  chapter and the standards adopted by the board under this chapter.
  [Sections 167.103-167.150 reserved for expansion]
  SUBCHAPTER D. CERTIFICATE RENEWAL
         Sec. 167.151.  EXPIRATION OF CERTIFICATE. (a)  A
  certificate issued under this chapter expires on the second
  anniversary of the date it is issued.
         (b)  The board shall grant a 180-day grace period from the
  expiration date of a certificate to renew the certificate.
         (c)  The owner or operator of a pain management clinic for
  which a certificate has expired may not continue to operate the
  clinic until the clinic's certificate is renewed.
         Sec. 167.152.  REQUIREMENTS FOR RENEWAL. (a)  The owner or
  operator of a pain management clinic may apply to renew a
  certificate issued to the clinic under this chapter by:
               (1)  submitting a renewal application to the board on
  the form prescribed by the board before the expiration of the grace
  period under Section 167.151; and
               (2)  complying with any other requirements adopted by
  board rule.
         (b)  If a certificate is not renewed before the expiration of
  the grace period under Section 167.151, the pain management clinic
  must reapply for an original certificate to operate the clinic.
  [Sections 167.153-167.200 reserved for expansion]
  SUBCHAPTER E. REGULATION OF CLINICS; ENFORCEMENT
         Sec. 167.201.  REGULATION OF PERSON AFFILIATED WITH CLINIC.
  (a)  The owner or operator of a pain management clinic, an employee
  of the clinic, or a person with whom a clinic contracts for services
  may not:
               (1)  have been denied, by any jurisdiction, a license
  under which the person may prescribe, dispense, administer, supply,
  or sell a controlled substance;
               (2)  have held a license issued by any jurisdiction,
  under which the person may prescribe, dispense, administer, supply,
  or sell a controlled substance, that has been restricted; or
               (3)  have been subject to disciplinary action by any
  licensing entity for conduct that was a result of inappropriately
  prescribing, dispensing, administering, supplying, or selling a
  controlled substance.
         (b)  A pain management clinic may not be owned wholly or
  partly by a person who has been convicted of or pled nolo contendere
  to, or received deferred adjudication for:
               (1)  an offense that constitutes a felony; or
               (2)  an offense that constitutes a misdemeanor, the
  facts of which relate to the distribution of illegal prescription
  drugs or a controlled substance as defined by Section 551.003(11).
         (c)  The owner or operator of a pain management clinic shall:
               (1)  be on-site at the clinic at least 33 percent of the
  clinic's total number of operating hours; and
               (2)  review at least 33 percent of the total number of
  patient files of the clinic, including the patient files of a clinic
  employee or contractor to whom authority for patient care has been
  delegated by the clinic.
         Sec. 167.202.  DISCIPLINARY ACTION. (a)  A violation of
  this chapter or a rule adopted under this chapter is grounds for
  disciplinary action against a pain management clinic certified
  under this chapter or an owner or operator of a clinic certified
  under this chapter.
         (b)  A violation of this chapter may be enforced in the same
  manner as any other violation of this subtitle.
         SECTION 2.  (a)  Not later than March 1, 2010, the Texas
  Medical Board shall adopt the rules required by Chapter 167,
  Occupations Code, as added by this Act.
         (b)  Notwithstanding Section 167.101, Occupations Code, as
  added by this Act, a pain management clinic must obtain a
  certificate required by that section not later than September 1,
  2010.
         SECTION 3.  (a)  Except as provided by Subsection (b) of
  this section, this Act takes effect September 1, 2009.
         (b)  Section 167.101, Occupations Code, as added by this Act,
  takes effect September 1, 2010.