Bill Text: TX SB1001 | 2011-2012 | 82nd Legislature | Comm Sub
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Relating to the practice of certain professions regulated under the Occupations Code and the payment and reimbursement of certain professionals.
Spectrum: Slight Partisan Bill (Republican 2-1)
Status: (Engrossed - Dead) 2011-05-24 - Placed on General State Calendar [SB1001 Detail]
Download: Texas-2011-SB1001-Comm_Sub.html
Bill Title: Relating to the practice of certain professions regulated under the Occupations Code and the payment and reimbursement of certain professionals.
Spectrum: Slight Partisan Bill (Republican 2-1)
Status: (Engrossed - Dead) 2011-05-24 - Placed on General State Calendar [SB1001 Detail]
Download: Texas-2011-SB1001-Comm_Sub.html
82R25228 E | ||
By: Carona, et al. | S.B. No. 1001 | |
(Chisum) | ||
Substitute the following for S.B. No. 1001: No. |
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relating to the practice of certain professions regulated under the | ||
Occupations Code and the payment and reimbursement of certain | ||
professionals. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subtitle A, Title 3, Occupations Code, is | ||
amended by adding Chapter 115 to read as follows: | ||
CHAPTER 115. ABILITY TO PRACTICE PROFESSION | ||
Sec. 115.001. PURPOSE. The purpose of this chapter is to | ||
ensure that certain persons licensed under this title may practice | ||
their professions to the full extent authorized by law in | ||
accordance with the person's education, training, and licensing. | ||
Sec. 115.002. COLLABORATION BETWEEN PHYSICIANS AND | ||
CHIROPRACTORS. A person licensed under Subtitle B and a person | ||
licensed under Chapter 201 are authorized to: | ||
(1) collaborate with each other in providing services | ||
to a client if each person performs only those services that the | ||
person is authorized under state law, rules, or regulations to | ||
perform; or | ||
(2) use objective or subjective means to analyze, | ||
examine, evaluate, or otherwise determine the condition of the | ||
person's client for the purpose of: | ||
(A) providing services to the client that the | ||
person is authorized under state laws, rules, or regulations to | ||
provide; or | ||
(B) referring the client to an appropriate person | ||
licensed under this title for the provision of services needed by | ||
the client. | ||
Sec. 115.003. AUTHORITY TO FORM CERTAIN ENTITIES AND | ||
ASSOCIATIONS. (a) A person licensed under Subtitle B and a person | ||
licensed under Chapter 201 may form a partnership, professional | ||
association, or professional limited liability company according | ||
to the requirements of this section and any other applicable law. | ||
(b) When persons licensed under Chapter 201 form a | ||
professional entity with persons licensed under Subtitle B, as | ||
provided by this section, the authority of each practitioner is | ||
limited by that practitioner's scope of practice, and a | ||
practitioner may not exercise control over another practitioner's | ||
clinical authority granted by the other practitioner's license, | ||
either through agreements, bylaws, directives, financial | ||
incentives, or other arrangements that would assert control over | ||
treatment decisions made by the practitioner. | ||
(c) The state agencies exercising regulatory control over | ||
professions to which this section applies continue to exercise | ||
regulatory authority over their respective licenses. | ||
(d) A person licensed under Subtitle B who forms a | ||
professional entity under this section shall report the formation | ||
of the entity and any material change in agreements, bylaws, | ||
directives, financial incentives, or other arrangements related to | ||
the operation of the entity to the Texas Medical Board no later than | ||
the 30th day after the entity is formed or the material change is | ||
made. | ||
Sec. 115.004. BILLING AND REIMBURSEMENT FOR SERVICES. (a) A | ||
person licensed under Chapter 201 may use the same billing codes | ||
used by a person licensed under Chapter 453 if the billing codes | ||
describe services that the person is authorized to provide under | ||
state law, rules, or regulations. | ||
(b) If physical modalities and procedures are covered | ||
services under a health insurance policy, as defined by Section | ||
1451.101, Insurance Code, and within the scope of the license of a | ||
chiropractor and one or more other type of practitioner, a health | ||
insurance policy issuer shall comply with Section 1451.109, | ||
Insurance Code, and any other applicable law. | ||
SECTION 2. Section 1451.109, Insurance Code, is amended to | ||
read as follows: | ||
Sec. 1451.109. SELECTION OF CHIROPRACTOR. (a) An insured | ||
may select a chiropractor to provide the medical or surgical | ||
services or procedures scheduled in the health insurance policy | ||
that are within the scope of the chiropractor's license. | ||
(b) If physical modalities and procedures are covered | ||
services under a health insurance policy and within the scope of the | ||
license of a chiropractor and one or more other type of | ||
practitioner, a health insurance policy issuer may not: | ||
(1) deny payment or reimbursement for physical | ||
modalities and procedures provided by a chiropractor if: | ||
(A) the chiropractor provides the modalities and | ||
procedures in strict compliance with laws and rules relating to a | ||
chiropractor's license; and | ||
(B) the health insurance policy issuer allows | ||
payment or reimbursement for the same physical modalities and | ||
procedures performed by another type of practitioner; | ||
(2) make payment or reimbursement for particular | ||
covered physical modalities and procedures within the scope of a | ||
chiropractor's practice contingent on treatment or examination by a | ||
practitioner that is not a chiropractor; or | ||
(3) establish other limitations on the provision of | ||
covered physical modalities and procedures that would prohibit an | ||
insured from seeking the covered physical modalities and procedures | ||
from a chiropractor to the same extent that the insured may obtain | ||
covered physical modalities and procedures from another type of | ||
practitioner. | ||
(c) Nothing in this section requires a health insurance | ||
policy issuer to cover particular services or affects the ability | ||
of a health insurance policy issuer to determine whether specific | ||
procedures for which payment or reimbursement is requested are | ||
medically necessary. | ||
(d) This section does not apply to: | ||
(1) workers' compensation insurance coverage as | ||
defined by Section 401.011, Labor Code; | ||
(2) a self-insured employee welfare benefit plan | ||
subject to the Employee Retirement Income Security Act of 1974 (29 | ||
U.S.C. Section 1001 et seq.); | ||
(3) the child health plan program under Chapter 62, | ||
Health and Safety Code, or the health benefits plan for children | ||
under Chapter 63, Health and Safety Code; or | ||
(4) a Medicaid managed care program operated under | ||
Chapter 533, Government Code, or a Medicaid program operated under | ||
Chapter 32, Human Resources Code. | ||
SECTION 3. The changes in law made by this Act to Section | ||
1451.109, Insurance Code, apply only to a health insurance policy | ||
that is delivered, issued for delivery, or renewed on or after the | ||
effective date of this Act. A policy delivered, issued for | ||
delivery, or renewed before the effective date of this Act is | ||
governed by the law as it existed immediately before the effective | ||
date of this Act, and that law is continued in effect for that | ||
purpose. | ||
SECTION 4. This Act takes effect September 1, 2011. |