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S.B. No. 872
AN ACT
relating to a study regarding the impact of niche hospitals on other
general hospitals, to certain reports and disclosure requirements
regarding niche hospitals, and to the establishment of an advisory
panel to conduct a study on the reporting of health care associated
infection rates and process measures.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 105.002, Occupations Code, is amended by
amending Subsection (a) and adding Subsections (c) and (d) to read
as follows:
(a) A health care provider commits unprofessional conduct
if the health care provider, in connection with the provider's
professional activities:
(1) knowingly presents or causes to be presented a
false or fraudulent claim for the payment of a loss under an
insurance policy; [or]
(2) knowingly prepares, makes, or subscribes to any
writing, with intent to present or use the writing, or to allow it
to be presented or used, in support of a false or fraudulent claim
under an insurance policy; or
(3) knowingly directs or requires a patient to obtain
health care goods or services from a niche hospital in which the
health care provider or an immediate family member of the provider
has a financial interest, unless the provider:
(A) discloses to the patient, in writing, that
the provider or the provider's family member has a financial
interest in the niche hospital; and
(B) informs the patient that the patient has the
option of using an alternative health care facility.
(c) Subsection (a)(3) does not apply to a financial interest
in publicly available shares of a registered investment company,
such as a mutual fund, that owns publicly traded equity securities
or debt obligations issued by a niche hospital or an entity that
owns the niche hospital.
(d) In this section:
(1) "Diagnosis-related group" means the
classification system mandated by Medicare regulations for
reimbursement purposes that groups patients according to principal
diagnosis, presence of a surgical procedure, age, presence or
absence of significant complications, and other relevant criteria.
(2) "Niche hospital" means a hospital that:
(A) classifies at least two-thirds of the
hospital's Medicare patients or, if data is available, all
patients:
(i) in not more than two major
diagnosis–related groups; or
(ii) in surgical diagnosis-related groups;
(B) specializes in one or more of the following
areas:
(i) cardiac;
(ii) orthopedics;
(iii) surgery; or
(iv) women's health; and
(C) is not:
(i) a public hospital;
(ii) a hospital for which the majority of
inpatient claims are for major diagnosis-related groups relating to
rehabilitation, psychiatry, alcohol and drug treatment, or
children or newborns; or
(iii) a hospital with fewer than 10 claims
per bed per year.
SECTION 2. Subchapter B, Chapter 162, Occupations Code, is
amended by adding Section 162.052 to read as follows:
Sec. 162.052. NOTICE OF CERTAIN OWNERSHIP INTERESTS.
(a) In this section, "niche hospital" has the meaning assigned by
Section 105.002.
(b) A physician shall notify the Department of State Health
Services of any ownership interest held by the physician in a niche
hospital.
(c) Subsection (b) does not apply to an ownership interest
in publicly available shares of a registered investment company,
such as a mutual fund, that owns publicly traded equity securities
or debt obligations issued by a niche hospital or an entity that
owns the niche hospital.
(d) The board, in consultation with the Department of State
Health Services, shall adopt rules governing the form and content
of the notice required by Subsection (b).
SECTION 3. Subtitle D, Title 2, Health and Safety Code, is
amended by adding Chapter 96 to read as follows:
CHAPTER 96. HEALTH CARE ASSOCIATED INFECTION RATE
AND PROCESS MEASURE REPORTING
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 96.001. DEFINITIONS. (a) In this chapter:
(1) "Advisory panel" means the Advisory Panel on
Health Care Associated Infections.
(2) "Commissioner" means the commissioner of state
health services.
(3) "Department" means the Department of State Health
Services.
(4) "Health care associated infection" means a
localized or symptomatic condition resulting from an adverse
reaction to an infectious agent or its toxins to which a patient is
exposed in the course of health care delivery.
(5) "Health care facility" means a hospital licensed
under Chapter 241 or an ambulatory surgical center licensed under
Chapter 243.
(6) "Infection rate" means the number of health care
associated infections at a health care facility divided by a
numerical measure over time of the population at risk for
contracting the infection.
(7) "Process measure" means a measure of a health care
facility's compliance with recommended infection control
practices.
(b) The advisory panel may modify or define the term
"infection rate" as necessary to accomplish the purposes of this
chapter.
Sec. 96.002. APPLICABILITY OF OTHER LAW. Chapter 2110,
Government Code, does not apply to the advisory panel created under
Subchapter B.
Sec. 96.003. EXPIRATION. This chapter expires January 1,
2007.
[Sections 96.004-96.050 reserved for expansion]
SUBCHAPTER B. ADVISORY PANEL ON
HEALTH CARE ASSOCIATED INFECTIONS
Sec. 96.051. ESTABLISHMENT. The commissioner shall
establish the Advisory Panel on Health Care Associated Infections
within the regulatory licensing unit of the health care quality
section of the department.
Sec. 96.052. MEMBERSHIP. The advisory panel is composed of
14 members as follows:
(1) two infection control practitioner members who:
(A) are certified by the Certification Board of
Infection Control and Epidemiology; and
(B) are practicing in hospitals in this state, at
least one of which must be a rural hospital;
(2) two infection control practitioner members who:
(A) are certified by the Certification Board of
Infection Control and Epidemiology; and
(B) are nurses licensed to engage in professional
nursing under Chapter 301, Occupations Code;
(3) three board-certified or board-eligible physician
members who:
(A) are licensed to practice medicine in this
state under Chapter 155, Occupations Code, at least two of whom have
active medical staff privileges at a hospital in this state;
(B) are active members of the Society for
Healthcare Epidemiology of America; and
(C) have demonstrated expertise in infection
control in health care facilities;
(4) one member who is a chief executive officer of a
hospital licensed under Chapter 241;
(5) one member who is a chief executive officer of an
ambulatory surgical center licensed under Chapter 243;
(6) three members who:
(A) are department employees representing the
department in epidemiology and the licensing of hospitals or
ambulatory surgical centers; and
(B) serve as nonvoting members of the advisory
panel; and
(7) two members who represent the public as consumers.
Sec. 96.053. MEMBER ELIGIBILITY. A person may not be a
member of the advisory panel if the person is required to register
as a lobbyist under Chapter 305, Government Code, because of the
person's activities for compensation on behalf of a profession
related to health care.
Sec. 96.054. OFFICERS. The members of the advisory panel
shall elect a presiding officer and an assistant presiding officer
from among the members.
Sec. 96.055. COMPENSATION; EXPENSES. (a) Except as
provided by Subsection (b), a member of the advisory panel is not
entitled to compensation for service on the advisory panel and is
not entitled to reimbursement for travel expenses.
(b) A member who is a representative of a state agency shall
be reimbursed for travel expenses incurred while conducting the
business of the advisory panel from the funds of the agency the
person represents in accordance with the General Appropriations
Act.
Sec. 96.056. VACANCY. A vacancy on the advisory panel shall
be filled by the commissioner.
Sec. 96.057. ABOLISHED. The Advisory Panel on Health Care
Associated Infections is abolished January 1, 2007.
[Sections 96.058-96.100 reserved for expansion]
SUBCHAPTER C. POWERS AND DUTIES OF ADVISORY PANEL
Sec. 96.101. GENERAL POWERS AND DUTIES. (a) The advisory
panel, using nationally accepted measures, shall study and
recommend definitions and methodologies for collecting and
reporting evidence-based data on:
(1) infection rates;
(2) process measures; or
(3) both infection rates and process measures.
(b) In developing the recommendations described in
Subsection (a), the advisory panel shall consider:
(1) adjusting the reported infection rates to account
for the differences in patient populations and for factors outside
the control of the health care facility;
(2) standardizing data collection methodology and
reporting;
(3) reviewing data collection and reporting systems of
other entities related to infection rates, such as the National
Nosocomial Infections Surveillance System of the federal Centers
for Disease Control and Prevention;
(4) reviewing data collection and reporting systems of
other entities related to process measures, such as the Joint
Commission on Accreditation of Healthcare Organizations or the
Centers for Medicare and Medicaid Services;
(5) maximizing the efficient use of the resources
required for health care facilities to conduct required
surveillance and reporting;
(6) recognizing the potential unintended consequences
of public reporting that is poorly designed or executed and that may
diminish the overall quality of this state's health care or mislead
or fail to protect health care consumers who use the data; and
(7) providing additional benefits to health care
consumers.
Sec. 96.102. REPORT TO LEGISLATURE. (a) Not later than
November 1, 2006, the commissioner shall file a report with the
presiding officer of each house of the legislature on the advisory
panel's recommendations for legislation regarding the collection
and reporting of infection rates, process measures, or both.
(b) The report shall include a recommendation that the
legislation set September 1, 2007, as the date for hospitals and
ambulatory surgical centers to comply with the legislation.
SECTION 4. Section 108.011, Health and Safety Code, is
amended by adding Subsections (c-1) and (c-2) to read as follows:
(c-1) The council shall use public use data to prepare and
issue reports that provide information for review and analysis by
the Health and Human Services Commission relating to services that
are provided in a niche hospital, as defined by Section 105.002,
Occupations Code, and that are provided by a physician with an
ownership interest in the niche hospital.
(c-2) Subsection (c-1) does not apply to an ownership
interest in publicly available shares of a registered investment
company, such as a mutual fund, that owns publicly traded equity
securities or debt obligations issued by a niche hospital or an
entity that owns the niche hospital.
SECTION 5. (a) In this section, "niche hospital" has the
meaning assigned by Section 105.002, Occupations Code.
(b) The Department of State Health Services shall conduct a
study regarding the impact of niche hospitals on the financial
viability of other general hospitals located in this state.
(c) In conducting the study, the Department of State Health
Services shall evaluate:
(1) the number of niche hospitals currently operating
in this state;
(2) the number of niche hospitals in this state that
are currently under construction or in the planning phase of
construction;
(3) the location of each niche hospital and its
proximity to other general hospitals;
(4) the financial impact of niche hospitals on other
general hospitals;
(5) the referral patterns of physicians with an
ownership interest in a niche hospital as compared to the referral
patterns of physicians with privileges at a niche hospital who do
not have an ownership interest in the niche hospital; and
(6) the range of services provided by niche hospitals
in this state, with particular emphasis on the provision of
emergency and charity care services.
(d) Not later than December 1, 2006, the Department of State
Health Services shall submit a report to the legislature regarding
the results of the study conducted under this section.
(e) This section expires September 1, 2007.
SECTION 6. Section 105.002, Occupations Code, as amended by
this Act, applies only to conduct that occurs on or after the
effective date of this Act. Conduct that occurs 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 7. As soon as practicable after the effective date
of this Act, the commissioner of the Department of State Health
Services shall appoint members to the Advisory Panel on Health Care
Associated Infections as required by Chapter 96, Health and Safety
Code, as added by this Act.
SECTION 8. This Act takes effect September 1, 2005.
______________________________ ______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 872 passed the Senate on
April 12, 2005, by the following vote: Yeas 30, Nays 0, one
present not voting; May 27, 2005, Senate refused to concur in House
amendments and requested appointment of Conference Committee;
May 28, 2005, House granted request of the Senate; May 28, 2005,
Senate adopted Conference Committee Report by the following
vote: Yeas 31, Nays 0.
______________________________
Secretary of the Senate
I hereby certify that S.B. No. 872 passed the House, with
amendments, on May 23, 2005, by a non-record vote; May 28, 2005,
House granted request of the Senate for appointment of Conference
Committee; May 29, 2005, House adopted Conference Committee Report
by the following vote: Yeas 138, Nays 2, two present not voting.
______________________________
Chief Clerk of the House
Approved:
______________________________
Date
______________________________
Governor