Bill Text: TX SB1980 | 2015-2016 | 84th 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 (Democrat 1-0)
Status: (Introduced - Dead) 2015-03-25 - Referred to Health & Human Services [SB1980 Detail]
Download: Texas-2015-SB1980-Introduced.html
84R7918 SCL-D | ||
By: Garcia | S.B. No. 1980 |
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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 Subsection (d) to read as follows: | ||
(d) For purposes of Subsection (a)(13), 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. | ||
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 of the commission 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), 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) 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(gg), Human Resources Code, is | ||
amended to read as follows: | ||
(gg) Notwithstanding any other law, including Sections | ||
843.312 and 1301.052, Insurance Code, the department 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 department. 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 department to supervise or control the practice of medicine as | ||
prohibited by Subtitle B, Title 3, Occupations Code. The | ||
department 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 | ||
department. | ||
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) 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. | ||
(b) If a health maintenance organization contracts directly | ||
with an advanced practice nurse under Subsection (a), the physician | ||
delegating to or supervising the advanced practice nurse is part of | ||
an applicable limited provider network for purposes of supervision. | ||
(c) 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) 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. | ||
(b) If an insurer designates an advanced practice nurse as a | ||
preferred provider under Subsection (a), the physician delegating | ||
to or supervising the advanced practice nurse is a preferred | ||
provider for purposes of supervision. | ||
(c) 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, 2015. |