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A BILL TO BE ENTITLED
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AN ACT
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relating to the right of a dentist to contract for certain services. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Chapter 251, Occupations Code, is amended by |
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adding Section 251.0041 to read as follows: |
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Sec. 251.0041. IMPROPER INFLUENCE ON PROFESSIONAL |
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JUDGMENT. (a) In this section, the term "dentist" includes: |
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(1) a dentist licensed by the board; |
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(2) a professional corporation wholly owned by one or |
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more dentists licensed by the board; and |
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(3) a professional entity that provides dental |
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services and is owned solely by one or more dentists licensed by the |
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board. |
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(b) A dentist who enters into any contract or other |
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agreement that allows a person other than a dentist one or more of |
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the following rights or authorities is presumed to have allowed the |
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other person to control, influence, or otherwise interfere with the |
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exercise of the dentist's independent professional judgment |
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regarding the diagnosis or treatment of a dental disease, disorder, |
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or physical condition: |
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(1) controlling, owning, or setting any conditions for |
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access to or the specific contents of dental records of patients of |
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a dentist; |
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(2) setting a maximum or other standardized time for |
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the performance of specific dental procedures; |
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(3) placing any limitation or requirement on |
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treatments, referrals, or consultations except those based on the |
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professional judgment of the dentist; |
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(4) limiting or imposing requirements concerning the |
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type or scope of dental treatment, procedures, or services that may |
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be recommended, prescribed, directed, or performed, except that a |
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dentist may limit the dentist's practice, or the practice of a |
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dentist employed by or contracting with the dentist, to certain |
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procedures or the treatment of certain dental diseases; |
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(5) limiting or imposing requirements concerning the |
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supplies, instruments, or equipment deemed reasonably necessary by |
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a dentist to provide diagnoses and treatment of the patients of the |
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dentist, including a restriction on the use of a dentist's money for |
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the purchase of supplies, instruments, or equipment; |
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(6) limiting or imposing requirements for the |
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professional training deemed necessary by the dentist to properly |
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serve the patients of the dentist; |
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(7) directing or influencing the selection of specific |
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diagnostic examinations and treatments or practices regarding |
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patients without due regard to the recommended diagnostic |
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examinations and treatment agreed upon by the dentist and the |
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patient, except that a dentist having the responsibility for |
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training or supervising another dentist may reasonably limit |
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treatments or practices as a part of the training or supervision of |
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a dentist based upon the training and competency of a dentist to |
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perform certain treatments or practices; |
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(8) limiting or determining the duties of |
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professional, clinical, or other personnel employed to assist a |
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dentist in the practice of dentistry; |
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(9) establishing professional standards, protocols, |
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or practice guidelines which, in the professional judgment of the |
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dentist providing dental service to the dentist's patient, conflict |
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with generally accepted standards within the dental profession; |
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(10) encouraging impermissible referrals from |
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unlicensed persons in consideration of a fee; |
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(11) placing limitations or conditions upon |
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communications that are clinical in nature with the dentist's |
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patients; |
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(12) precluding or restricting a dentist's ability to |
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exercise independent professional judgment over all qualitative |
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and quantitative aspects of the delivery of dental care; |
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(13) scheduling patients of the dentist in a manner |
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that may have the effect of discouraging new patients from coming |
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into the dentist's practice or postponing future appointments or |
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giving scheduling preference to an individual, class, or group; |
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(14) penalizing a dentist for reporting violations of |
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a law regulating the practice of dentistry; |
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(15) conditioning the payment of fees to a dentist or |
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the amount of management fees a dentist must pay on the referral of |
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patients to other health care providers specified by a non-dentist; |
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or |
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(16) interfering with a dentist's decision regarding |
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the refund of any payment made by a patient for dental services. |
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(c) If a person who is not a dentist enters into any contract |
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or other agreement with a dentist that allows the person one or more |
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of the following rights or authorities, the person is presumed not |
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to have engaged in the practice of dentistry as defined by Section |
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251.003 without a license or to have been allowed to control, |
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influence, or otherwise interfere with the exercise of the |
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dentist's independent professional judgment regarding the |
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diagnosis or treatment of any dental disease, disorder, or physical |
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condition: |
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(1) leases, mortgages, ownership agreements, or other |
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arrangements regarding use of space for dental offices based on a |
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fee or amount that is reasonably related to the fair market value of |
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the office space at the time the lease or other arrangement is |
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entered into; |
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(2) the purchase, sale, financing, or lease of dental |
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equipment, instruments, and supplies as long as the dentist |
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maintains the complete care, custody, and control of the dental |
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equipment, instruments, and supplies and the lease does not provide |
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for a payment or fee based upon a percentage of the revenue received |
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by the dentist or the dental practice; |
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(3) accounting, bookkeeping, banking, investment, or |
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similar financial services, including services related to the |
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payment of invoices, obligations, and debts of a dentist; |
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(4) the financing, lease, use, or ownership of |
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non-dentist business equipment such as telephones, computers, |
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software, and general office equipment at reasonable, |
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market-related fees; |
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(5) services regarding the pledge, collection, or sale |
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of accounts receivable from patients; |
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(6) billing and collection services; |
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(7) advertising and marketing services as long as the |
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dentist remains solely responsible for the content of any |
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advertising or marketing services and for ensuring that the |
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advertising and marketing services conform to all applicable legal |
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requirements; |
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(8) consulting and advising regarding professional |
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development, business practices, and third party payor |
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arrangements, and the provision of business and other nonclinical |
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services for the day-to-day operation of a dental office which do |
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not limit the dentist's ability to use the dentist's independent |
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professional judgment regarding the diagnosis or treatment of any |
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dental disease, disorder, or physical condition; |
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(9) employing or retaining the services of personnel |
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working in a dental office, other than the dentist; or |
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(10) providing loans, capital, or funding to a |
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dentist, including under a secured arrangement. |
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(d)(1) The presumption established by Subsection (b) may be |
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rebutted by evidence that the contract or agreement did not result |
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in a person who is not a dentist controlling, influencing, or |
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otherwise interfering with the exercise of the dentist's |
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independent professional judgment regarding the diagnosis or |
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treatment of any dental disease, disorder, or physical condition. |
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(2) The presumption established by Subsection (c) may |
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be rebutted by evidence that the contract or agreement actually |
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resulted in a person who is not a dentist controlling, influencing, |
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or otherwise interfering with the dentist's independent |
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professional judgment regarding the diagnosis or treatment of any |
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dental disease, disorder, or physical condition. Evidence is not |
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admissible to rebut the presumption established by Subsection (c) |
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if the evidence relates to: |
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(A) the length of the contract or agreement; |
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(B) whether an unlicensed person provides all, |
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substantially all, or is the exclusive provider of such |
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undertakings to a dentist or dental office; or |
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(C) subject to the limitations of Subsection |
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(b)(5), whether the dentist has authorized an unlicensed person to |
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have signature authority over the dentist's accounts. |
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(e) This rule does not apply to a person or circumstance |
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described by Section 251.004, 260.001, 260.002, 260.003, or |
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260.004. |
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SECTION 2. Section 254.0011, Occupations Code, is amended |
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to read as follows: |
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Sec. 254.0011. RULES RELATING TO CONTROL OF DENTAL |
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PRACTICE. [(a)] The board may not adopt rules [relating to the
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practice of dentistry as described by Section 251.003(a)(9)] to |
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prohibit or otherwise restrict [a dentist from engaging in
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contracts that allow a person who is not a dentist to influence or
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interfere with the exercise of the dentist's independent
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professional judgment.
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[(b)
Rules adopted by the board under this subtitle may not
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preclude] a dentist's right to contract with: |
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(1) a management service organization; or |
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(2) a person for the provision of management services. |
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[Rules affecting contracts for provision of management services
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apply the same to dentists contracting with management service
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organizations and to dentists otherwise contracting for management
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services.] |
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SECTION 3. This Act takes effect September 1, 2015. |