Bill Text: TX HB2807 | 2017-2018 | 85th Legislature | Introduced


Bill Title: Relating to the participation of an advanced practice nurse as a primary care provider for certain governmental and other health benefit plans.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2017-04-25 - Left pending in committee [HB2807 Detail]

Download: Texas-2017-HB2807-Introduced.html
  85R12890 SCL-D
 
  By: Price H.B. No. 2807
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the participation of an advanced practice nurse as a
  primary care provider for certain governmental and other health
  benefit plans.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 533.005, Government Code, is amended by
  adding Subsections (d) and (e) to read as follows:
         (d)  For purposes of Subsection (a)(13) and subject to
  Subsection (e), an advanced practice nurse, including an advanced
  practice nurse certified as a psychiatric/mental health advanced
  practice nurse, may be included as a primary care provider in a
  managed care organization's provider network regardless of whether
  the physician delegating to or supervising the advanced practice
  nurse under Subchapter B, Chapter 157, Occupations Code, is in the
  provider network. If a managed care organization includes an
  advanced practice nurse as a primary care provider under this
  subsection, the physician delegating to or supervising the advanced
  practice nurse is part of the network for purposes of supervision.
  This subsection may not be construed as authorizing a managed care
  organization to supervise or control the practice of medicine as
  prohibited by Subtitle B, Title 3, Occupations Code.
         (e)  Subsection (d) applies only to an advanced practice
  nurse practicing in a county:
               (1)  in which there are no practicing physicians; and
               (2)  that:
                     (A)  has been designated as a medically
  underserved area under state or federal law; or
                     (B)  contains a medically underserved population.
         SECTION 2.  Section 62.1551, Health and Safety Code, is
  amended to read as follows:
         Sec. 62.1551.  INCLUSION OF CERTAIN HEALTH CARE PROVIDERS IN
  PROVIDER NETWORKS. (a)  Notwithstanding any other law, including
  Sections 843.312 and 1301.052, Insurance Code, the executive
  commissioner shall adopt rules to require a managed care
  organization or other entity to ensure that advanced practice
  registered nurses and physician assistants are available as primary
  care providers in the organization's or entity's provider network.  
  The rules must require advanced practice registered nurses and
  physician assistants to be treated in the same manner as primary
  care physicians with regard to:
               (1)  selection and assignment as primary care
  providers;
               (2)  inclusion as primary care providers in the
  provider network; and
               (3)  inclusion as primary care providers in any
  provider network directory maintained by the organization or
  entity.
         (b)  For purposes of Subsection (a) and subject to Subsection
  (c), an advanced practice nurse, including an advanced practice
  nurse certified as a psychiatric/mental health advanced practice
  nurse, may be included as a primary care provider in a managed care
  organization's or entity's provider network regardless of whether
  the physician delegating to or supervising the advanced practice
  nurse under Subchapter B, Chapter 157, Occupations Code, is in the
  provider network. If a managed care organization or other entity
  includes an advanced practice nurse as a primary care provider
  under this subsection, the physician delegating to or supervising
  the advanced practice nurse is part of the provider network for
  purposes of supervision.
         (c)  Subsection (b) applies only to an advanced practice
  nurse practicing in a county:
               (1)  in which there are no practicing physicians; and
               (2)  that:
                     (A)  has been designated as a medically
  underserved area under state or federal law; or
                     (B)  contains a medically underserved population.
         (d)  This section may not be construed as authorizing a
  managed care organization or other entity to supervise or control
  the practice of medicine as prohibited by Subtitle B, Title 3,
  Occupations Code.
         SECTION 3.  Section 32.024, Human Resources Code, is amended
  by amending Subsection (gg) and adding Subsection (gg-1) to read as
  follows:
         (gg)  Subject to Subsection (gg-1) and notwithstanding
  [Notwithstanding] any other law, including Sections 843.312 and
  1301.052, Insurance Code, the commission shall ensure that advanced
  practice registered nurses, including advanced practice registered
  nurses certified as psychiatric/mental health advanced practice
  nurses, and physician assistants may be selected by and assigned to
  recipients of medical assistance as the primary care providers of
  those recipients regardless of whether the physician delegating to
  or supervising the advanced practice registered nurse under
  Subchapter B, Chapter 157, Occupations Code, is included in any
  directory of providers of medical assistance maintained by the
  commission. If an advanced practice registered nurse is included
  as a primary care provider under this subsection, the physician
  delegating to or supervising the advanced practice registered nurse
  is included in the directory for purposes of supervision. This
  subsection may not be construed as authorizing the commission to
  supervise or control the practice of medicine as prohibited by
  Subtitle B, Title 3, Occupations Code. The commission must require
  that advanced practice registered nurses and physician assistants
  be treated in the same manner as primary care physicians with regard
  to:
               (1)  selection and assignment as primary care
  providers; and
               (2)  inclusion as primary care providers in any
  directory of providers of medical assistance maintained by the
  commission.
         (gg-1)  Subsection (gg) applies only to an advanced practice
  nurse practicing in a county:
               (1)  in which there are no practicing physicians; and
               (2)  that:
                     (A)  has been designated as a medically
  underserved area under state or federal law; or
                     (B)  contains a medically underserved population.
         SECTION 4.  Subchapter I, Chapter 843, Insurance Code, is
  amended by adding Section 843.3125 to read as follows:
         Sec. 843.3125.  CONTRACTS WITH ADVANCED PRACTICE NURSES.
  (a) This section applies only to an advanced practice nurse
  practicing in a county:
               (1)  in which there are no practicing physicians; and
               (2)  that:
                     (A)  has been designated as a medically
  underserved area under state and federal law; or
                     (B)  contains a medically underserved population.
         (b)  A health maintenance organization may contract directly
  with an advanced practice nurse to provide health care services on
  behalf of the health maintenance organization regardless of whether
  the physician delegating to or supervising the advanced practice
  nurse under Subchapter B, Chapter 157, Occupations Code, provides
  health care services for the health maintenance organization.
         (c)  If a health maintenance organization contracts directly
  with an advanced practice nurse under Subsection (b), the physician
  delegating to or supervising the advanced practice nurse is part of
  an applicable limited provider network for purposes of supervision.
         (d)  This section may not be construed as authorizing a
  health maintenance organization to supervise or control the
  practice of medicine as prohibited by Subtitle B, Title 3,
  Occupations Code.
         SECTION 5.  Subchapter B, Chapter 1301, Insurance Code, is
  amended by adding Section 1301.0525 to read as follows:
         Sec. 1301.0525.  DESIGNATION OF ADVANCED PRACTICE NURSES AS
  PREFERRED PROVIDERS. (a) This section applies only to an advanced
  practice nurse practicing in a county:
               (1)  in which there are no practicing physicians; and
               (2)  that:
                     (A)  has been designated as a medically
  underserved area under state and federal law; or
                     (B)  contains a medically underserved population.
         (b)  An insurer offering a preferred provider benefit plan
  may designate an advanced practice nurse as a preferred provider
  regardless of whether the physician delegating to or supervising
  the advanced practice nurse under Subchapter B, Chapter 157,
  Occupations Code, is a preferred provider.
         (c)  If an insurer designates an advanced practice nurse as a
  preferred provider under Subsection (b), the physician delegating
  to or supervising the advanced practice nurse is a preferred
  provider for purposes of supervision.
         (d)  This section may not be construed as authorizing an
  insurer to supervise or control the practice of medicine as
  prohibited by Subtitle B, Title 3, Occupations Code.
         SECTION 6.  If before implementing any provision of this Act
  a state agency determines that a waiver or authorization from a
  federal agency is necessary for implementation of that provision,
  the agency affected by the provision shall request the waiver or
  authorization and may delay implementing that provision until the
  waiver or authorization is granted.
         SECTION 7.  This Act takes effect September 1, 2017.
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