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A BILL TO BE ENTITLED
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AN ACT
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relating to health organizations certified by the Texas Medical |
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Board under Subchapter A, Chapter 162, Occupations Code. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter A, Chapter 162, Occupations Code is |
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amended by adding Sections 162.004 through 162.006. |
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Sec. 162.004. NON-INTERFERENCE WITH PHYSICIAN PROFESSIONAL |
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JUDGMENT. A health organization certified under Section 162.001(b) |
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shall not interfere with, control, or otherwise direct a |
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physician's professional judgment in contravention of this |
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subchapter, or any other provision of law, including board rules. |
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Sec. 162.005. NO CONTRACTUAL WAIVER. The requirements of |
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this subchapter may not be voided or waived by contract. |
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Sec. 162.006. HEALTH ORGANIZATION POLICIES. (a) A health |
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organization certified under Section 162.001(b) shall adopt, |
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maintain, and enforce policies to ensure that a physician employed |
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by the health organization exercises independent medical judgment |
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when providing care to patients. |
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(b) The policies adopted under this section must include |
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policies relating to: |
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(1) credentialing and privileges; |
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(2) quality assurance; |
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(3) utilization review; |
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(4) peer review; |
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(5) medical decision-making; |
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(6) due process; and |
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(7) delegation of authority. |
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(c) The policies adopted under this section, including any |
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amendments to the policies, must be approved by an affirmative vote |
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of the medical staff of the health organization prior to adoption by |
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the board of directors of the health organization. |
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(d) The policies adopted under this section must include the |
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implementation of a complaint mechanism for processing and |
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resolving complaints regarding interference or attempted |
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interference with the physician's independent medical judgment. |
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The policies must address the manner in which the public can access |
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board complaint procedures. |
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(e) The policies and bylaws of the health organization must |
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be drafted and interpreted in a manner that reserves the sole |
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authority to engage in the practice of medicine to the physicians on |
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the medical staff, regardless of the physician's employment status |
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with the health organization. |
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(f) The policies and bylaws adopted or approved by the |
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medical staff shall control and prevail in the event of a conflict |
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with any other policies of the health organization. |
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SECTION 2. This Act takes effect September 1, 2011. |