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  H.B. No. 3201
 
 
 
 
AN ACT
  relating to the practice of dentistry; imposing surcharges and
  fees.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 254.004, Occupations Code, is amended by
  adding Subsections (c) and (d) to read as follows:
         (c)  The board shall collect an additional $55 surcharge for
  each of the following fees:
               (1)  the fee for the issuance of a dental license; and
               (2)  the fee for the renewal of a dental license.
         (d)  The board shall deposit each surcharge collected to the
  credit of the dental public assurance account. The dental public
  assurance account is an account in the general revenue fund that
  shall be appropriated only to the board to pay for the board's
  enforcement program, including an expert panel.
         SECTION 2.  Section 254.006(b), Occupations Code, is amended
  to read as follows:
         (b)  Investigation files and other records are confidential,
  except the board shall inform the license holder of the specific
  allegations against the license holder [and shall be divulged only
  to the persons investigated at the completion of the
  investigation]. The board may share investigation files and other
  records with another state regulatory agency or a local, state, or
  federal law enforcement agency.
         SECTION 3.  Section 254.018, Occupations Code, is amended to
  read as follows:
         Sec. 254.018.  [EXPERT] TESTIMONY. A member of the board may
  not express an oral or written opinion or serve as an expert witness
  in a civil action that is:
               (1)  related to an administrative matter within the
  board's jurisdiction;
               (2)  brought [suit involving a health care liability
  claim] against or for a person licensed or registered under this
  subtitle; and
               (3)  [dentist] for the injury to or death of a patient
  or for a violation of the standard of care or the commission of
  malpractice [unless the member receives approval from the board or
  an executive committee of the board to serve as an expert witness].
         SECTION 4.  Chapter 254, Occupations Code, is amended by
  adding Section 254.019 to read as follows:
         Sec. 254.019.  DEFINITIONS. (a)  In this section:
               (1)  "Dental service agreement" means an agreement
  between a dental service organization and a dentist under which the
  dental service organization will:
                     (A)  provide services related to the nonclinical
  business aspects of a dental practice, including arranging or
  providing financing, performing billing or payroll tasks,
  processing patient insurance claims, scheduling or otherwise
  interacting with patients, and performing other administrative
  tasks;
                     (B)  supervise or manage the employees or
  contractors of the dentist; or
                     (C)  employ or otherwise contract with a dentist
  in the dentist's capacity as a dentist.
               (2)  "Dental service organization" means an entity
  that:
                     (A)  is owned wholly or partly by a person who is
  or is not a dentist; and
                     (B)  under a dental service agreement, provides or
  offers to provide services to a dentist or employs or otherwise
  contracts with a dentist in the dentist's capacity as a dentist.
         (b)  The board shall collect the following information from
  dentists licensed by the board in conjunction with the issuance and
  renewal of each dental license:
               (1)  the number and type of dentists employed by the
  license holder, if any;
               (2)  the name under which the license holder provides
  dental services and each location at which those services are
  provided by that license holder;
               (3)  whether the license holder is a participating
  provider under the Medicaid program operated under Chapter 32,
  Human Resources Code, or the child health plan program operated
  under Chapter 62, Health and Safety Code;
               (4)  whether the license holder is employed by or
  contracts with a dental service organization and, if so, the name
  and address of the dental service organization;
               (5)  whether the license holder owns all or part of a
  dental service organization and, if so, the name and address of the
  dental service organization and of each dental office at which the
  dental service organization provides services to patients;
               (6)  whether the license holder is a party to a dental
  service agreement and, if so, the name and address of the dental
  service organization that provides services under the agreement;
  and
               (7)  if the license holder owns all or part of a dental
  service organization, whether that practice is a party to a dental
  service agreement and, if so, the name and address of the dental
  service organization that provides services under the agreement.
         (c)  If requested by the board, a dental service organization
  shall provide to the board the address of the locations where the
  organization provides dental services in this state and the name of
  each dentist providing dental services at each location.
         (d)  The board shall provide an option for the electronic
  submission of the information required under this section.
         (e)  Not later than November 1 of each even-numbered year,
  the board shall provide a report to the legislature on the
  information collected under this section and on the board's use of
  the information in the exercise of the board's statutory authority
  to regulate the practice of dentistry.
         SECTION 5.  Sections 255.006(a) and (d-1), Occupations Code,
  are amended to read as follows:
         (a)  A complaint received under this chapter must be filed
  with and reviewed by the board to determine jurisdiction. If the
  board has jurisdiction, the board shall complete a preliminary
  investigation of the complaint not later than the 60th day after the
  date of receiving [investigate the complaint to determine the facts
  concerning] the complaint. The board shall first determine whether
  the license holder constitutes a continuing threat to the public
  welfare. On completion of the preliminary investigation, the board
  shall determine whether to officially proceed on the complaint. If
  the board fails to complete the preliminary investigation in the
  time required by this subsection, the board's official
  investigation of the complaint is considered to commence on that
  date.
         (d-1)  Procedures established under Subsection (d)(6) must:
               (1)  [require a board employee to consult with a
  dentist member of the board before dismissing a complaint relating
  to patient morbidity, professional conduct, or quality of care;
               [(2)]  ensure that the decision to dismiss a complaint
  is made with the appropriate level of review and necessary
  expertise and experience; and
               (2) [(3)]  require the dismissal of a complaint to be
  reported to the board at a public meeting of the board.
         SECTION 6.  Chapter 255, Occupations Code, is amended by
  adding Sections 255.0065, 255.0066, and 255.0067 to read as
  follows:
         Sec. 255.0065.  COMPOSITION OF EXPERT PANELS. (a) The board
  by rule shall provide for expert panels appointed by the board to
  assist with complaints and investigations relating to professional
  competency by acting as expert dentist and dental hygienist
  reviewers.
         (b)  Each member of the expert dentist panel must be licensed
  to practice dentistry in this state. Each member of the expert
  dental hygienist panel must be licensed to practice dental hygiene
  in this state.
         (c)  The rules adopted under this section must include
  provisions governing the composition of the panel, qualifications
  for membership on the panel, length of time a member may serve on
  the panel, grounds for removal from the panel, the avoidance of
  conflicts of interest, including situations in which the affected
  license holder and the panel member live or work in the same
  geographical area or are competitors, and the duties to be
  performed by the panel.
         (d)  The board's rules governing grounds for removal from the
  panel must include providing for the removal of a panel member who
  is repeatedly delinquent in reviewing complaints and in submitting
  reports to the board.
         Sec. 255.0066.  DETERMINATION OF COMPETENCY. (a)  If the
  preliminary investigation under Section 255.006(a) indicates that
  an act by a license holder falls below an acceptable standard of
  care, the complaint shall be reviewed by an expert panel authorized
  under Section 255.0065 consisting of license holders who practice
  in the same specialty as the license holder who is the subject of
  the complaint or in another specialty that is similar to the license
  holder's specialty.
         (b)  The expert panel shall report in writing the panel's
  determinations based on the review of the complaint under
  Subsection (a). The report must specify the standard of care that
  applies to the facts that are the basis of the complaint and the
  clinical basis for the panel's determinations, including any
  reliance on peer-reviewed journals, studies, or reports.
         Sec. 255.0067.  REPORTS; PROCEDURES FOR EXPERT REVIEW.
  (a)  A license holder on an expert panel authorized by Section
  255.0065 who is initially selected to review a complaint shall:
               (1)  determine whether the license holder who is the
  subject of the complaint has violated the standard of care
  applicable to the circumstances; and
               (2)  issue a preliminary written report of that
  determination.
         (b)  A second expert reviewer shall review the first expert
  reviewer's preliminary report and other information associated
  with the complaint. If the second reviewer agrees with the first
  reviewer, the first reviewer shall issue a final written report on
  the matter.
         (c)  If the second expert reviewer does not agree with the
  conclusions of the first expert reviewer, a third expert reviewer
  shall review the preliminary report and information and decide
  between the conclusions reached by the first two reviewers. The
  final written report shall be issued by the third reviewer or the
  reviewer with whom the third reviewer concurs.
         (d)  In reviewing a complaint, the expert reviewers assigned
  to examine the complaint may consult and communicate with each
  other about the complaint in formulating their opinions and
  reports.
         SECTION 7.  Subchapter C, Chapter 256, Occupations Code, is
  amended by adding Section 256.106 to read as follows:
         Sec. 256.106.  DELEGATED AUTHORITY TO ISSUE LICENSES.  The
  board may delegate authority to board employees to issue licenses
  under this subtitle to applicants who clearly meet all licensing
  requirements. If the board employees determine that the applicant
  does not clearly meet all licensing requirements, the application
  shall be returned to the board. A license issued under this section
  does not require formal board approval.
         SECTION 8.  Subchapter B, Chapter 258, Occupations Code, is
  amended by adding Section 258.055 to read as follows:
         Sec. 258.055.  PRACTICE OF DENTISTRY ON CERTAIN CHILDREN.
  (a)  The parent or guardian of a child younger than 18 years of age
  may be present in the treatment room during the child's dental
  treatment or procedure, unless the dentist determines in the
  dentist's professional judgment that the presence of the parent or
  guardian in the treatment room is likely to have an adverse effect
  on the treatment or the child.
         (b)  In this section, "parent or guardian" includes a person
  authorized by law to consent for the medical or dental treatment of
  a child younger than 18 years of age.
         SECTION 9.  Chapter 263, Occupations Code, is amended by
  adding Sections 263.0065, 263.0076, and 263.0077 to read as
  follows:
         Sec. 263.0065.  DELEGATION OF CERTAIN COMPLAINT
  DISPOSITIONS.  (a) The board may delegate to a committee of board
  employees the authority to dismiss or enter into an agreed
  settlement of a complaint that does not relate directly to patient
  care or that involves only administrative violations.
         (b)  The disposition determined by the committee must be
  approved by the board at a public meeting.
         (c)  A complaint delegated under this section shall be
  referred for informal proceedings under Section 263.0075 if:
               (1)  the committee of employees determines that the
  complaint should not be dismissed or settled;
               (2)  the committee is unable to reach an agreed
  settlement; or
               (3)  the affected license holder requests that the
  complaint be referred for informal proceedings.
         Sec. 263.0076.  INFORMAL SETTLEMENT CONFERENCE NOTICE. (a)
  If an informal settlement conference will be held under Section
  263.0075, notice of the time and place of the conference must be
  given to the license holder not later than the 45th day before the
  date the conference is held.
         (b)  The notice required by Subsection (a) must be
  accompanied by a written statement of the specific allegations
  against the license holder and the information the board intends to
  use at the informal settlement conference. If the board does not
  provide the statement or information when the notice is provided,
  the license holder may use that failure as grounds for rescheduling
  the conference.
         (c)  The license holder must provide to the board the license
  holder's rebuttal not later than the 15th day before the date of the
  conference in order for that information to be considered at the
  conference.
         (d)  On request by a license holder under review, the board
  shall make a recording of the informal settlement conference. The
  recording is a part of the investigative file and may not be
  released to a third party unless authorized under this subtitle.
  The board may charge the license holder a fee to cover the cost of
  recording the conference. The board shall provide a copy of the
  recording to the license holder on the license holder's request.
         Sec. 263.0077.  REMEDIAL PLAN. (a) The board may issue and
  establish the terms of a remedial plan to resolve the investigation
  of a complaint filed under this subtitle.
         (b)  A remedial plan may not contain a provision that:
               (1)  revokes, suspends, limits, or restricts a person's
  license or other authorization to practice dentistry or dental
  hygiene; or
               (2)  assesses an administrative penalty against a
  person.
         (c)  A remedial plan may not be imposed to resolve a
  complaint:
               (1)  concerning:
                     (A)  a patient death;
                     (B)  the commission of a felony; or
                     (C)  a matter in which the license holder engaged
  in inappropriate sexual behavior or contact with a patient or
  became financially or personally involved with a patient in an
  inappropriate manner; or
               (2)  in which the appropriate resolution may involve a
  restriction on the manner in which a license holder practices
  dentistry or dental hygiene.
         (d)  The board may not issue a remedial plan to resolve a
  complaint against a license holder if the license holder has
  previously entered into a remedial plan with the board for the
  resolution of a different complaint filed under this subtitle.
         (e)  The board may assess a fee against a license holder
  participating in a remedial plan in an amount necessary to recover
  the costs of administering the plan.
         (f)  A remedial plan is public information.
         (g)  In civil litigation, a remedial plan is a settlement
  agreement under Rule 408, Texas Rules of Evidence.
         (h)  The board shall adopt rules necessary to implement this
  section.
         SECTION 10.  Not later than December 1, 2013, the State Board
  of Dental Examiners shall adopt rules necessary to implement the
  changes in law made by this Act.
         SECTION 11.  Section 254.004(c), Occupations Code, as added
  by this Act, applies only to an application for an original dental
  license or for renewal of a dental license filed on or after
  September 1, 2013. An application filed before September 1, 2013,
  is governed by the law in effect immediately before that date, and
  that law is continued in effect for that purpose.
         SECTION 12.  Sections 254.006(b) and 255.006, Occupations
  Code, as amended by this Act, and Sections 255.0065, 255.0066,
  255.0067, 263.0076, and 263.0077, Occupations Code, as added by
  this Act, apply only to the investigation and resolution of a
  complaint filed with the State Board of Dental Examiners on or after
  January 1, 2014.  A complaint filed before that date is governed by
  the law in effect on the date the complaint was filed, and the
  former law is continued in effect for that purpose.
         SECTION 13.  (a) Except as provided by Subsection (b) of
  this section, this Act takes effect January 1, 2014.
         (b)  Section 10 of this Act and Sections 254.004(c) and (d)
  and 254.019, Occupations Code, as added by this Act, take effect
  September 1, 2013.
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
 
         I certify that H.B. No. 3201 was passed by the House on May 3,
  2013, by the following vote:  Yeas 140, Nays 2, 1 present, not
  voting; and that the House concurred in Senate amendments to H.B.
  No. 3201 on May 22, 2013, by the following vote:  Yeas 141, Nays 3,
  2 present, not voting.
 
  ______________________________
  Chief Clerk of the House   
 
         I certify that H.B. No. 3201 was passed by the Senate, with
  amendments, on May 20, 2013, by the following vote:  Yeas 31, Nays
  0.
 
  ______________________________
  Secretary of the Senate   
  APPROVED: __________________
                  Date       
   
           __________________
                Governor