Bill Text: TX SB1148 | 2017-2018 | 85th Legislature | Comm Sub
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Relating to maintenance of certification by a physician or an applicant for a license to practice medicine in this state.
Spectrum: Strong Partisan Bill (Republican 13-1)
Status: (Passed) 2017-06-15 - Effective on 1/1/18 [SB1148 Detail]
Download: Texas-2017-SB1148-Comm_Sub.html
Bill Title: Relating to maintenance of certification by a physician or an applicant for a license to practice medicine in this state.
Spectrum: Strong Partisan Bill (Republican 13-1)
Status: (Passed) 2017-06-15 - Effective on 1/1/18 [SB1148 Detail]
Download: Texas-2017-SB1148-Comm_Sub.html
By: Buckingham, et al. | S.B. No. 1148 | |
(In the Senate - Filed February 28, 2017; March 7, 2017, | ||
read first time and referred to Committee on Business & Commerce; | ||
April 24, 2017, reported adversely, with favorable Committee | ||
Substitute by the following vote: Yeas 8, Nays 0; April 24, 2017, | ||
sent to printer.) | ||
COMMITTEE SUBSTITUTE FOR S.B. No. 1148 | By: Campbell |
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relating to maintenance of certification by a physician or an | ||
applicant for a license to practice medicine in this state; | ||
authorizing a fee. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subtitle F, Title 8, Insurance Code, is amended | ||
by adding Chapter 1461 to read as follows: | ||
CHAPTER 1461. DISCRIMINATION AGAINST PHYSICIAN BASED ON | ||
MAINTENANCE OF CERTIFICATION | ||
Sec. 1461.001. DEFINITIONS. In this chapter: | ||
(1) "Enrollee" means an individual who is eligible to | ||
receive health care services under a managed care plan. | ||
(2) "Maintenance of certification" has the meaning | ||
assigned by Section 151.002, Occupations Code. | ||
(3) "Managed care plan" means a health benefit plan | ||
under which medical care services are provided to enrollees through | ||
contracts with physicians and that requires enrollees to use | ||
participating physicians or that provides a different level of | ||
coverage for enrollees who use participating physicians. The term | ||
includes a health benefit plan issued by: | ||
(A) a health maintenance organization; | ||
(B) a preferred provider benefit plan issuer; or | ||
(C) any other entity that issues a health benefit | ||
plan, including an insurance company. | ||
(4) "Participating physician" means a physician who | ||
has directly or indirectly contracted with a health benefit plan | ||
issuer to provide services to enrollees. | ||
(5) "Physician" means a person licensed to practice | ||
medicine in this state. | ||
Sec. 1461.002. APPLICABILITY. (a) This chapter applies to | ||
a physician regardless of whether the physician is a participating | ||
physician. | ||
(b) This chapter applies to a person to whom a managed care | ||
plan issuer contracts to: | ||
(1) process or pay claims; | ||
(2) obtain the services of physicians to provide | ||
medical care services to enrollees; or | ||
(3) issue verifications or preauthorizations. | ||
Sec. 1461.003. DISCRIMINATION BASED ON MAINTENANCE OF | ||
CERTIFICATION. (a) Except as provided by Subsection (b), a | ||
managed care plan issuer may not differentiate between physicians | ||
based on a physician's maintenance of certification in regard to: | ||
(1) paying the physician; | ||
(2) reimbursing the physician; or | ||
(3) directly or indirectly contracting with the | ||
physician to provide services to enrollees. | ||
(b) A managed care plan issuer may differentiate between | ||
physicians based on a physician's maintenance of certification | ||
only: | ||
(1) if the entity that administers the physician's | ||
maintenance of certification is certified under Chapter 170, | ||
Occupations Code; and | ||
(2) after the issuer considers the physician's: | ||
(A) training; | ||
(B) experience; | ||
(C) competence; and | ||
(D) judgment. | ||
(c) A managed care plan issuer may not differentiate between | ||
physicians based on the entity that administers a physician's | ||
maintenance of certification. | ||
SECTION 2. Section 151.002(a), Occupations Code, is amended | ||
by adding Subdivision (6-b) to read as follows: | ||
(6-b) "Maintenance of certification" means the | ||
satisfactory completion of periodic recertification requirements | ||
that are required for a physician to maintain certification after | ||
initial certification under a medical specialty member board, | ||
including the member boards of the American Board of Medical | ||
Specialties or the specialty certifying boards of the American | ||
Osteopathic Association. | ||
SECTION 3. Subchapter A, Chapter 151, Occupations Code, is | ||
amended by adding Section 151.006 to read as follows: | ||
Sec. 151.006. CERTIFICATION OF MEDICAL SPECIALTY. | ||
Notwithstanding any other law, a physician is considered a | ||
board-certified medical specialist in this state if the physician | ||
receives initial certification by a medical specialty board, | ||
regardless of the physician's maintenance of certification. | ||
SECTION 4. Subchapter B, Chapter 151, Occupations Code, is | ||
amended by adding Section 151.0515 to read as follows: | ||
Sec. 151.0515. DISCRIMINATION BASED ON MAINTENANCE OF | ||
CERTIFICATION. (a) Except as provided by Subsection (b), a | ||
hospital, institution, or program that is licensed by this state, | ||
is operated by this state or a political subdivision of this state, | ||
or directly or indirectly receives state financial assistance may | ||
not differentiate between physicians based on a physician's | ||
maintenance of certification. | ||
(b) An entity described by Subsection (a) may differentiate | ||
between physicians based on a physician's maintenance of | ||
certification only: | ||
(1) if the entity that administers the physician's | ||
maintenance of certification is certified under Chapter 170; and | ||
(2) after the entity considers the physician's: | ||
(A) training; | ||
(B) experience; | ||
(C) competence; and | ||
(D) judgment. | ||
(c) An entity described by Subsection (a) may not | ||
differentiate between physicians based on the entity that | ||
administers a physician's maintenance of certification. | ||
(d) A state agency, including the Health and Human Services | ||
Commission and the Department of State Health Services, may not | ||
require a hospital or other provider to require maintenance of | ||
certification by a physician. | ||
SECTION 5. Section 155.003, Occupations Code, is amended by | ||
amending Subsection (d) and adding Subsection (d-1) to read as | ||
follows: | ||
(d) Except as provided by Subsection (d-1), in [ |
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to the other requirements prescribed by this subtitle, the board | ||
may require an applicant to comply with other requirements that the | ||
board considers appropriate. | ||
(d-1) The board may not require maintenance of | ||
certification by an applicant for the applicant to be eligible for a | ||
license under this chapter. | ||
SECTION 6. Section 156.001, Occupations Code, is amended by | ||
adding Subsection (f) to read as follows: | ||
(f) The board may not adopt a rule requiring maintenance of | ||
certification by a license holder for the license holder to be | ||
eligible for an initial or renewal registration permit. | ||
SECTION 7. Subtitle B, Title 3, Occupations Code, is | ||
amended by adding Chapter 170 to read as follows: | ||
CHAPTER 170. ENTITY CERTIFICATION TO PROVIDE MAINTENANCE OF | ||
CERTIFICATION | ||
Sec. 170.001. CERTIFICATE TO PROVIDE MAINTENANCE OF | ||
CERTIFICATION. (a) The board shall establish a process to issue a | ||
certificate authorizing an entity to provide maintenance of | ||
certification for physicians. | ||
(b) The board by rule shall establish the minimum number of | ||
continuing medical education hours that are required for | ||
maintenance of certification in a particular medical specialty by | ||
an entity under this chapter. | ||
Sec. 170.002. FEES. The board may set a reasonable | ||
application fee for a certificate under this chapter. | ||
Sec. 170.003. APPLICATION FOR CERTIFICATE. (a) The board | ||
shall prescribe the form of an application for a certificate under | ||
this chapter. | ||
(b) The application must require the applicant to provide: | ||
(1) the applicant's legal name, mailing address, | ||
telephone number, and business address; | ||
(2) the particular practice area in which the | ||
applicant will offer maintenance of certification; | ||
(3) the requirements the applicant will impose on a | ||
physician for maintenance of certification; and | ||
(4) the amount of any fees the applicant will charge a | ||
physician for maintenance of certification. | ||
Sec. 170.004. ISSUANCE OF CERTIFICATE. The board shall | ||
issue a certificate under this chapter to an applicant that: | ||
(1) submits an application on the form prescribed by | ||
the board under Section 170.003; | ||
(2) pays the required fee; and | ||
(3) demonstrates to the satisfaction of the board that | ||
the applicant's maintenance of certification program complies with | ||
Sections 170.005 and 170.006. | ||
Sec. 170.005. REQUIREMENTS FOR MAINTENANCE OF | ||
CERTIFICATION. A maintenance of certification program provided by | ||
a holder of a certificate under this chapter: | ||
(1) must require a physician seeking maintenance of | ||
certification to complete at least the minimum number of continuing | ||
medical education hours set by board rule under Section 170.001(b); | ||
and | ||
(2) other than continuing medical education hours, may | ||
not require a physician initially certified by the entity to | ||
complete any educational or testing requirement, including | ||
periodic testing, proprietary self-assessment, or peer evaluation. | ||
Sec. 170.006. PRACTICE IMPROVEMENT PROGRAM. (a) A holder | ||
of a certificate under this chapter shall administer a practice | ||
improvement program to encourage continued improvement within the | ||
medical profession. | ||
(b) A practice improvement program under Subsection (a) | ||
must focus on recent scientific developments, improving patient | ||
safety, patient or population health outcomes, access to health | ||
care, and patient experience, and increasing value in the health | ||
care system. | ||
Sec. 170.007. ADVERTISING AS BOARD-CERTIFIED SPECIALIST. A | ||
physician who holds current maintenance of certification from a | ||
certificate holder under this chapter may advertise that the | ||
physician is a board-certified specialist in the area of medical | ||
specialty in which the physician holds the maintenance of | ||
certification. | ||
SECTION 8. The Texas Medical Board shall adopt rules to | ||
implement Chapter 170, Occupations Code, as added by this Act, not | ||
later than September 1, 2018. | ||
SECTION 9. This Act takes effect January 1, 2018. | ||
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