S.B. No. 1148

	AN ACT
	relating to maintenance of certification by a physician or an
	applicant for a license to practice medicine in this state.
	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 health 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 an individual 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 with whom a managed
	care plan issuer contracts to:
	(1)  process or pay claims;
	(2)  obtain the services of physicians to provide
	health 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
	if the designation under law or certification or accreditation by a
	national certifying or accrediting organization of an entity
	described by Section 151.0515(a), Occupations Code, is contingent
	on the entity requiring a specific maintenance of certification by
	physicians seeking staff privileges or credentialing at the entity.
	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 from:
	(A)  a medical specialty member board of the
	American Board of Medical Specialties;
	(B)  a medical specialty member board of the
	American Osteopathic Association Bureau of Osteopathic
	Specialists;
	(C)  the American Board of Oral and Maxillofacial
	Surgery; or
	(D)  any other certifying board that is recognized
	by the Texas Medical Board.
	SECTION 3.  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 otherwise provided by this section,
	the following entities may not differentiate between physicians
	based on a physician's maintenance of certification:
	(1)  a health facility that is licensed under Subtitle
	B, Title 4, Health and Safety Code, or a mental hospital that is
	licensed under Chapter 577, Health and Safety Code, if the facility
	or hospital has an organized medical staff or a process for
	credentialing physicians;
	(2)  a hospital that is owned or operated by this state;
	(3)  an institution or program that is owned, operated,
	or licensed by this state, including an institution or program that
	directly or indirectly receives state financial assistance, if the
	institution or program:
	(A)  has an organized medical staff or a process
	for credentialing physicians on its staff; and
	(B)  is not a medical school, as defined by
	Section 61.501, Education Code, or a comprehensive cancer center,
	as designated by the National Cancer Institute; or
	(4)  an institution or program that is owned, operated,
	or licensed by a political subdivision of this state, if the
	institution or program has an organized medical staff or a process
	for credentialing physicians on its staff.
	(b)  An entity described by Subsection (a) may differentiate
	between physicians based on a physician's maintenance of
	certification if:
	(1)  the entity's designation under law or
	certification or accreditation by a national certifying or
	accrediting organization is contingent on the entity requiring a
	specific maintenance of certification by physicians seeking staff
	privileges or credentialing at the entity; and
	(2)  the differentiation is limited to those physicians
	whose maintenance of certification is required for the entity's
	designation, certification, or accreditation as described by
	Subdivision (1).
	(c)  An entity described by Subsection (a) may differentiate
	between physicians based on a physician's maintenance of
	certification if the voting physician members of the entity's
	organized medical staff vote to authorize the differentiation.
	(d)  An authorization described by Subsection (c) may:
	(1)  be made only by the voting physician members of the
	entity's organized medical staff and not by the entity's governing
	body, administration, or any other person;
	(2)  subject to Subsection (e), establish terms
	applicable to the entity's differentiation, including:
	(A)  appropriate grandfathering provisions; and
	(B)  limiting the differentiation to certain
	medical specialties; and
	(3)  be rescinded at any time by a vote of the voting
	physician members of the entity's organized medical staff.
	(e)  Terms established under Subsection (d)(2) may not
	conflict with a maintenance of certification requirement
	applicable to the entity's designation under law or certification
	or accreditation by a national certifying or accrediting
	organization.
	SECTION 4.  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 [In] addition
	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 5.  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 6.  This Act takes effect January 1, 2018.
	______________________________	______________________________
	President of the Senate	Speaker of the House
	I hereby certify that S.B. No. 1148 passed the Senate on
	April 27, 2017, by the following vote:  Yeas 31, Nays 0;
	May 25, 2017, Senate refused to concur in House amendments and
	requested appointment of Conference Committee; May 26, 2017, House
	granted request of the Senate; May 28, 2017, Senate adopted
	Conference Committee Report by the following vote:  Yeas 30,
	Nays 1.
	______________________________
	Secretary of the Senate
	I hereby certify that S.B. No. 1148 passed the House, with
	amendments, on May 24, 2017, by the following vote:  Yeas 140,
	Nays 4, one present not voting; May 26, 2017, House granted request
	of the Senate for appointment of Conference Committee;
	May 28, 2017, House adopted Conference Committee Report by the
	following vote:  Yeas 144, Nays 2, two present not voting.
	______________________________
	Chief Clerk of the House
	Approved:
	______________________________
	Date
	______________________________
	Governor