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A BILL TO BE ENTITLED
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AN ACT
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relating to the authorization of certain agreements between |
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management services organizations and physicians. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subtitle A, Title 5, Business & Commerce Code, is |
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amended by adding Chapter 74 to read as follows: |
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CHAPTER 74. MANAGEMENT SERVICES ORGANIZATIONS FOR PHYSICIANS |
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Sec. 74.001. DEFINITION. In this chapter, "physician" |
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means an individual licensed to practice medicine in this state. |
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Sec. 74.002. AGREEMENTS WITH MANAGEMENT SERVICES |
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ORGANIZATIONS. A physician or group of physicians, whether or not |
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incorporated, may enter into a written agreement with a management |
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services organization for management and administrative services. |
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Sec. 74.003. SERVICES PROVIDED BY MANAGEMENT SERVICES |
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ORGANIZATIONS. (a) A management services organization, under the |
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terms of a management services agreement, may provide the following |
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for a physician or group of physicians: |
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(1) facilities; |
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(2) medical supplies and equipment, other than an item |
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considered a medical device by the United States Food and Drug |
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Administration; |
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(3) instruments and supplies other than prescription |
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drugs; |
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(4) business, office, and other nonmedical equipment; |
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(5) repair, maintenance, renovation, or replacement |
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services for any facility or equipment; |
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(6) accounting, payroll, bookkeeping, budget, |
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investment, tax compliance, and similar financial services; |
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(7) information and information systems and services, |
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provided that patient records in the systems are owned and freely |
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accessed by the physician; |
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(8) billing and collection services for the |
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physician's fees and charges; |
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(9) the collection or sale of the physician's accounts |
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receivable; |
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(10) advertising, marketing, and public relations |
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services in compliance with rules adopted by the Texas Medical |
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Board; |
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(11) payer and other relevant contract negotiation, |
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drafting, and similar services; |
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(12) receptionist, scheduling, messaging, and similar |
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coordination services; |
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(13) assistance in obtaining licenses and |
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registration permits necessary to operate a medical practice that |
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may be obtained by: |
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(A) a non-physician; or |
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(B) a physician, if the Texas Medical Board |
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approves the method of payment for the license or registration |
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permit renewal paid by the management services organization; |
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(14) recruiting, continuing education, training, |
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legal assistance, and logistical peer review services; |
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(15) insurance, purchasing, and claims services, |
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which may include maintaining the physician and the physician's |
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medical personnel on the same insurance policies and benefit plans |
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as the management services organization; |
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(16) consulting, business, and financial planning |
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services; |
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(17) establishment of prices to be charged to the |
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physician's patients for goods and supplies, other than for drugs |
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or medical devices, that are provided or managed by the management |
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services organization; |
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(18) assistance in the collection, analysis, and |
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submission of quality and patient satisfaction information to |
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physicians, other providers, regulatory agencies, and |
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accreditation bodies; |
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(19) the employment of persons who: |
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(A) perform management services; |
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(B) are physicians who perform administrative |
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and management services but not the practice of medicine; |
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(C) perform management, administrative, |
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clerical, receptionist, secretarial, bookkeeping, accounting, |
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payroll, billing, collection, and other functions; or |
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(D) are medical or other personnel, provided that |
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a physician who is present at the practice location that engages in |
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the practice of medicine at the location has the right to: |
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(i) control the medically related |
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procedures, duties, and performance of the medical and other |
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personnel; and |
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(ii) suspend for medically related reasons |
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the medical and other personnel, unless the suspension is contrary |
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to legal requirements or rules; and |
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(20) any other nonclinical service that is not |
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prohibited by Subsection (b). |
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(b) A management services organization may not: |
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(1) control or intervene in a physician's practice of |
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medicine; |
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(2) employ a physician, either by employment agreement |
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or by independent contractor agreement, to practice medicine; |
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(3) dictate or otherwise make final decisions on the |
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compensation of a physician for the practice of medicine; |
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(4) control or intervene in a physician's diagnosis, |
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treatment, correction, change, manipulation, relief, or prevention |
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of disease, deformity, defect, injury, or other physical condition, |
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including the prescription, dosage determination, or |
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administration of a drug, biologic, anesthetic, apparatus, medical |
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device, or other therapeutic or diagnostic substance or technique; |
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(5) control or intervene in a physician's selection or |
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use of a type or quality of medical supply or pharmaceutical to be |
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used in the practice of medicine; |
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(6) determine the amount of time a physician may spend |
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with a patient; |
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(7) own drugs, unless the drugs are owned in |
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compliance with applicable state or federal law; |
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(8) own the medical records of a physician's patients; |
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(9) own or control medical devices, pharmaceuticals, |
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or drugs for use in patient treatment by a physician; |
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(10) dictate or otherwise make final decisions on fees |
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to be charged by a physician; |
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(11) mandate compliance with specific professional |
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standards, protocols, or practice guidelines relating to the |
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practice of medicine; |
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(12) place limitations or conditions on patient |
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communications that are clinical in nature; |
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(13) require a physician to make referrals in |
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violation of applicable state law; or |
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(14) penalize a physician for reporting violations of |
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a law regulating the practice of medicine. |
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(c) Notwithstanding Subsection (b)(11), a management |
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services organization may mandate compliance with legal and other |
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requirements necessary to practice medicine in this state. |
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(d) A physician or an entity in which physicians are the |
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sole owners, shareholders, or partners may perform the activities |
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described by Subsection (b). |
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Sec. 74.004. FEES FOR MANAGEMENT SERVICES. A management |
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services organization may charge a physician or group of physicians |
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a flat, fair market-based management fee for the provision of |
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management services. |
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Sec. 74.005. DISCLOSURE OF CONTRACT. (a) A physician or a |
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group of physicians that enters into a management services |
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agreement with a management services organization shall: |
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(1) make copies of the management services agreement |
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available for inspection by the Texas Medical Board at the main |
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office of the physician or group of physicians; and |
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(2) if the board opens an investigation against the |
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physician or group of physicians, make available to the board |
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copies of the management services agreement. |
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(b) A copy of a management services agreement produced under |
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this section is governed by Subtitle B, Title 3, Occupations Code, |
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and is confidential and not subject to disclosure under Chapter |
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552, Government Code. |
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SECTION 2. This Act takes effect September 1, 2023. |