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A BILL TO BE ENTITLED
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AN ACT
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relating to prohibiting certain discrimination against a physician |
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or an applicant for a license to practice medicine in this state. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 241.003, Health and Safety Code, is |
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amended by adding Subdivisions (7-a) and (16) to read as follows: |
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(7-a) "Maintenance of certification" has the meaning |
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assigned by Section 151.002, Occupations Code. |
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(16) "Specialty medical board certification" has the |
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meaning assigned by Section 151.002, Occupations Code. |
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SECTION 2. Subchapter A, Chapter 241, Health and Safety |
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Code, is amended by adding Section 241.011 to read as follows: |
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Sec. 241.011. DISCRIMINATION AGAINST PHYSICIAN BASED ON |
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SPECIALTY MEDICAL BOARD CERTIFICATION OR MAINTENANCE OF |
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CERTIFICATION. Notwithstanding any other law, the owner, operator, |
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or governing body of a hospital that is licensed in this state may |
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not: |
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(1) require a physician to obtain or maintain any form |
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of specialty medical board certification or maintenance of |
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certification to be eligible for medical staff membership or |
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professional privileges, including admitting privileges; or |
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(2) discriminate against, disfavor, or disadvantage a |
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physician who does not obtain or maintain specialty medical board |
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certification or maintenance of certification. |
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SECTION 3. Subtitle F, Title 8, Insurance Code, is amended |
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by adding Chapter 1461 to read as follows: |
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CHAPTER 1461. DISCRIMINATION AGAINST PHYSICIAN BASED ON MEDICAL |
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SPECIALTY BOARD CERTIFICATION OR MAINTENANCE OF CERTIFICATION |
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Sec. 1461.001. DEFINITIONS. In this chapter: |
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(1) "Enrollee" means an individual who is eligible to |
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receive health care services under a managed care plan. |
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(2) "Maintenance of certification" has the meaning |
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assigned by Section 151.002, Occupations Code. |
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(3) "Managed care plan" means a health benefit plan |
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under which medical care services are provided to enrollees through |
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contracts with physicians and that requires enrollees to use |
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participating physicians or that provides a different level of |
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coverage for enrollees who use participating physicians. The term |
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includes a health benefit plan issued by: |
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(A) a health maintenance organization; |
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(B) a preferred provider benefit plan issuer; or |
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(C) any other entity that issues a health benefit |
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plan, including an insurance company. |
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(4) "Participating physician" means a physician who |
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has directly or indirectly contracted with a health benefit plan |
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issuer to provide services to enrollees. |
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(5) "Physician" means a person licensed to practice |
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medicine in this state. |
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(6) "Specialty medical board certification" has the |
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meaning assigned by Section 151.002, Occupations Code. |
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Sec. 1461.002. APPLICABILITY. (a) This chapter applies to |
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a physician regardless of whether the physician is a participating |
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physician. |
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(b) This chapter applies to a person with whom a managed |
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care plan issuer contracts to: |
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(1) process or pay claims; |
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(2) obtain the services of physicians to provide |
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medical care services to enrollees; or |
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(3) issue verifications or preauthorizations. |
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Sec. 1461.003. DISCRIMINATION AGAINST PHYSICIAN BASED ON |
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SPECIALTY MEDICAL BOARD CERTIFICATION, MAINTENANCE OF |
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CERTIFICATION, OR STAFF PRIVILEGES. Notwithstanding any other law, |
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a managed care plan issuer may not: |
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(1) require for the payment or reimbursement of a |
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claim under the plan that a physician: |
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(A) obtain or maintain any form of specialty |
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medical board certification or maintenance of certification; or |
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(B) maintain hospital medical staff privileges; |
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or |
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(2) discriminate against, disfavor, or disadvantage a |
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physician who does not obtain or maintain specialty medical board |
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certification or maintenance of certification. |
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SECTION 4. Section 151.002(a), Occupations Code, is amended |
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by adding Subdivisions (6-b) and (13-a) to read as follows: |
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(6-b) "Maintenance of certification" means a process |
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of successful completion of periodic recertification examinations |
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that are required to maintain specialty medical board |
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certification. |
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(13-a) "Specialty medical board certification" means |
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certification by a board that specializes in one particular area of |
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medicine and typically requires additional and more strenuous |
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examinations than state licensing boards require to practice |
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medicine. |
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SECTION 5. Chapter 151, Occupations Code, is amended by |
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adding Subchapter C to read as follows: |
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SUBCHAPTER C. DISCRIMINATION AGAINST PHYSICIAN BASED ON MEDICAL |
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SPECIALTY BOARD CERTIFICATION OR MAINTENANCE OF CERTIFICATION |
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Sec. 151.101. DISCRIMINATION REGARDING PRACTICE OF |
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MEDICINE PROHIBITED. Notwithstanding any other law, the board may |
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not: |
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(1) require any form of specialty medical board |
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certification or maintenance of certification to practice medicine |
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in this state; or |
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(2) require any form of specialty medical board |
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certification or maintenance of certification for a person to be |
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eligible under this subtitle for: |
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(A) a license; or |
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(B) an initial or renewal registration permit. |
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Sec. 151.102. DISCRIMINATION BY STATE AGENCY PROHIBITED. |
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Notwithstanding any other law the board or another state agency may |
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not discriminate against, disfavor, or disadvantage a physician who |
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does not obtain or maintain specialty medical board certification |
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or maintenance of certification. |
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Sec. 151.103. DISCRIMINATION IN COMPACT PROHIBITED. |
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Notwithstanding any other law the board or another state agency may |
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not enter into a compact, including an interstate compact, that |
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discriminates against, disfavors, or disadvantages a physician who |
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does not obtain or maintain specialty medical board certification |
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or maintenance of certification. |
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SECTION 6. This Act takes effect September 1, 2017. |