2015S0323-1 02/24/15
 
  By: Uresti S.B. No. 960
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the right of a dentist to contract for certain services.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Chapter 251, Occupations Code, is amended by
  adding Section 251.0041 to read as follows:
         Sec. 251.0041.  IMPROPER INFLUENCE ON PROFESSIONAL
  JUDGMENT.  (a)  In this section, the term "dentist" includes:
               (1)  a dentist licensed by the board;
               (2)  a professional corporation wholly owned by one or
  more dentists licensed by the board; and
               (3)  a professional entity that provides dental
  services and is owned solely by one or more dentists licensed by the
  board.
         (b)  A dentist who enters into any contract or other
  agreement that allows a person other than a dentist one or more of
  the following rights or authorities is presumed to have allowed the
  other person to control, influence, or otherwise interfere with the
  exercise of the dentist's independent professional judgment
  regarding the diagnosis or treatment of a dental disease, disorder,
  or physical condition:
               (1)  controlling, owning, or setting any conditions for
  access to or the specific contents of dental records of patients of
  a dentist;
               (2)  setting a maximum or other standardized time for
  the performance of specific dental procedures;
               (3)  placing any limitation or requirement on
  treatments, referrals, or consultations except those based on the
  professional judgment of the dentist;
               (4)  limiting or imposing requirements concerning the
  type or scope of dental treatment, procedures, or services that may
  be recommended, prescribed, directed, or performed, except that a
  dentist may limit the dentist's practice, or the practice of a
  dentist employed by or contracting with the dentist, to certain
  procedures or the treatment of certain dental diseases;
               (5)  limiting or imposing requirements concerning the
  supplies, instruments, or equipment deemed reasonably necessary by
  a dentist to provide diagnoses and treatment of the patients of the
  dentist, including a restriction on the use of a dentist's money for
  the purchase of supplies, instruments, or equipment;
               (6)  limiting or imposing requirements for the
  professional training deemed necessary by the dentist to properly
  serve the patients of the dentist;
               (7)  directing or influencing the selection of specific
  diagnostic examinations and treatments or practices regarding
  patients without due regard to the recommended diagnostic
  examinations and treatment agreed upon by the dentist and the
  patient, except that a dentist having the responsibility for
  training or supervising another dentist may reasonably limit
  treatments or practices as a part of the training or supervision of
  a dentist based upon the training and competency of a dentist to
  perform certain treatments or practices;
               (8)  limiting or determining the duties of
  professional, clinical, or other personnel employed to assist a
  dentist in the practice of dentistry;
               (9)  establishing professional standards, protocols,
  or practice guidelines which, in the professional judgment of the
  dentist providing dental service to the dentist's patient, conflict
  with generally accepted standards within the dental profession;
               (10)  encouraging impermissible referrals from
  unlicensed persons in consideration of a fee;
               (11)  placing limitations or conditions upon
  communications that are clinical in nature with the dentist's
  patients;
               (12)  precluding or restricting a dentist's ability to
  exercise independent professional judgment over all qualitative
  and quantitative aspects of the delivery of dental care;
               (13)  scheduling patients of the dentist in a manner
  that may have the effect of discouraging new patients from coming
  into the dentist's practice or postponing future appointments or
  giving scheduling preference to an individual, class, or group;
               (14)  penalizing a dentist for reporting violations of
  a law regulating the practice of dentistry;
               (15)  conditioning the payment of fees to a dentist or
  the amount of management fees a dentist must pay on the referral of
  patients to other health care providers specified by a non-dentist;
  or
               (16)  interfering with a dentist's decision regarding
  the refund of any payment made by a patient for dental services.
         (c)  If a person who is not a dentist enters into any contract
  or other agreement with a dentist that allows the person one or more
  of the following rights or authorities, the person is presumed not
  to have engaged in the practice of dentistry as defined by Section
  251.003 without a license or to have been allowed to control,
  influence, or otherwise interfere with the exercise of the
  dentist's independent professional judgment regarding the
  diagnosis or treatment of any dental disease, disorder, or physical
  condition:
               (1)  leases, mortgages, ownership agreements, or other
  arrangements regarding use of space for dental offices based on a
  fee or amount that is reasonably related to the fair market value of
  the office space at the time the lease or other arrangement is
  entered into;
               (2)  the purchase, sale, financing, or lease of dental
  equipment, instruments, and supplies as long as the dentist
  maintains the complete care, custody, and control of the dental
  equipment, instruments, and supplies and the lease does not provide
  for a payment or fee based upon a percentage of the revenue received
  by the dentist or the dental practice;
               (3)  accounting, bookkeeping, banking, investment, or
  similar financial services, including services related to the
  payment of invoices, obligations, and debts of a dentist;
               (4)  the financing, lease, use, or ownership of
  non-dentist business equipment such as telephones, computers,
  software, and general office equipment at reasonable,
  market-related fees;
               (5)  services regarding the pledge, collection, or sale
  of accounts receivable from patients;
               (6)  billing and collection services;
               (7)  advertising and marketing services as long as the
  dentist remains solely responsible for the content of any
  advertising or marketing services and for ensuring that the
  advertising and marketing services conform to all applicable legal
  requirements;
               (8)  consulting and advising regarding professional
  development, business practices, and third party payor
  arrangements, and the provision of business and other nonclinical
  services for the day-to-day operation of a dental office which do
  not limit the dentist's ability to use the dentist's independent
  professional judgment regarding the diagnosis or treatment of any
  dental disease, disorder, or physical condition;
               (9)  employing or retaining the services of personnel
  working in a dental office, other than the dentist; or
               (10)  providing loans, capital, or funding to a
  dentist, including under a secured arrangement.
         (d)(1)  The presumption established by Subsection (b) may be
  rebutted by evidence that the contract or agreement did not result
  in a person who is not a dentist controlling, influencing, or
  otherwise interfering with the exercise of the dentist's
  independent professional judgment regarding the diagnosis or
  treatment of any dental disease, disorder, or physical condition.
               (2)  The presumption established by Subsection (c) may
  be rebutted by evidence that the contract or agreement actually
  resulted in a person who is not a dentist controlling, influencing,
  or otherwise interfering with the dentist's independent
  professional judgment regarding the diagnosis or treatment of any
  dental disease, disorder, or physical condition.  Evidence is not
  admissible to rebut the presumption established by Subsection (c)
  if the evidence relates to:
                     (A)  the length of the contract or agreement;
                     (B)  whether an unlicensed person provides all,
  substantially all, or is the exclusive provider of such
  undertakings to a dentist or dental office; or
                     (C)  subject to the limitations of Subsection
  (b)(5), whether the dentist has authorized an unlicensed person to
  have signature authority over the dentist's accounts.
         (e)  This rule does not apply to a person or circumstance
  described by Section 251.004, 260.001, 260.002, 260.003, or
  260.004.
         SECTION 2.  Section 254.0011, Occupations Code, is amended
  to read as follows:
         Sec. 254.0011.  RULES RELATING TO CONTROL OF DENTAL
  PRACTICE.  [(a)]  The board may not adopt rules [relating to the
  practice of dentistry as described by Section 251.003(a)(9)] to
  prohibit or otherwise restrict [a dentist from engaging in
  contracts that allow a person who is not a dentist to influence or
  interfere with the exercise of the dentist's independent
  professional judgment.
         [(b)     Rules adopted by the board under this subtitle may not
  preclude] a dentist's right to contract with:
               (1)  a management service organization; or
               (2)  a person for the provision of management services.  
  [Rules affecting contracts for provision of management services
  apply the same to dentists contracting with management service
  organizations and to dentists otherwise contracting for management
  services.]
         SECTION 3.  This Act takes effect September 1, 2015.