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  S.B. No. 1148
 
 
 
 
AN ACT
  relating to maintenance of certification by a physician or an
  applicant for a license to practice medicine in this state.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subtitle F, Title 8, Insurance Code, is amended
  by adding Chapter 1461 to read as follows:
  CHAPTER 1461. DISCRIMINATION AGAINST PHYSICIAN BASED ON
  MAINTENANCE OF CERTIFICATION
         Sec. 1461.001.  DEFINITIONS. In this chapter:
               (1)  "Enrollee" means an individual who is eligible to
  receive health care services under a managed care plan.
               (2)  "Maintenance of certification" has the meaning
  assigned by Section 151.002, Occupations Code.
               (3)  "Managed care plan" means a health benefit plan
  under which health care services are provided to enrollees through
  contracts with physicians and that requires enrollees to use
  participating physicians or that provides a different level of
  coverage for enrollees who use participating physicians.  The term
  includes a health benefit plan issued by:
                     (A)  a health maintenance organization;
                     (B)  a preferred provider benefit plan issuer; or
                     (C)  any other entity that issues a health benefit
  plan, including an insurance company.
               (4)  "Participating physician" means a physician who
  has directly or indirectly contracted with a health benefit plan
  issuer to provide services to enrollees.
               (5)  "Physician" means an individual licensed to
  practice medicine in this state.
         Sec. 1461.002.  APPLICABILITY. (a)  This chapter applies to
  a physician regardless of whether the physician is a participating
  physician.
         (b)  This chapter applies to a person with whom a managed
  care plan issuer contracts to:
               (1)  process or pay claims;
               (2)  obtain the services of physicians to provide
  health care services to enrollees; or
               (3)  issue verifications or preauthorizations.
         Sec. 1461.003.  DISCRIMINATION BASED ON MAINTENANCE OF
  CERTIFICATION. (a)  Except as provided by Subsection (b), a
  managed care plan issuer may not differentiate between physicians
  based on a physician's maintenance of certification in regard to:
               (1)  paying the physician;
               (2)  reimbursing the physician; or
               (3)  directly or indirectly contracting with the
  physician to provide services to enrollees.
         (b)  A managed care plan issuer may differentiate between
  physicians based on a physician's maintenance of certification only
  if the designation under law or certification or accreditation by a
  national certifying or accrediting organization of an entity
  described by Section 151.0515(a), Occupations Code, is contingent
  on the entity requiring a specific maintenance of certification by
  physicians seeking staff privileges or credentialing at the entity.
         SECTION 2.  Section 151.002(a), Occupations Code, is amended
  by adding Subdivision (6-b) to read as follows:
               (6-b)  "Maintenance of certification" means the
  satisfactory completion of periodic recertification requirements
  that are required for a physician to maintain certification after
  initial certification from:
                     (A)  a medical specialty member board of the
  American Board of Medical Specialties;
                     (B)  a medical specialty member board of the
  American Osteopathic Association Bureau of Osteopathic
  Specialists;
                     (C)  the American Board of Oral and Maxillofacial
  Surgery; or
                     (D)  any other certifying board that is recognized
  by the Texas Medical Board.
         SECTION 3.  Subchapter B, Chapter 151, Occupations Code, is
  amended by adding Section 151.0515 to read as follows:
         Sec. 151.0515.  DISCRIMINATION BASED ON MAINTENANCE OF
  CERTIFICATION. (a)  Except as otherwise provided by this section,
  the following entities may not differentiate between physicians
  based on a physician's maintenance of certification:
               (1)  a health facility that is licensed under Subtitle
  B, Title 4, Health and Safety Code, or a mental hospital that is
  licensed under Chapter 577, Health and Safety Code, if the facility
  or hospital has an organized medical staff or a process for
  credentialing physicians;
               (2)  a hospital that is owned or operated by this state;
               (3)  an institution or program that is owned, operated,
  or licensed by this state, including an institution or program that
  directly or indirectly receives state financial assistance, if the
  institution or program:
                     (A)  has an organized medical staff or a process
  for credentialing physicians on its staff; and
                     (B)  is not a medical school, as defined by
  Section 61.501, Education Code, or a comprehensive cancer center,
  as designated by the National Cancer Institute; or
               (4)  an institution or program that is owned, operated,
  or licensed by a political subdivision of this state, if the
  institution or program has an organized medical staff or a process
  for credentialing physicians on its staff.
         (b)  An entity described by Subsection (a) may differentiate
  between physicians based on a physician's maintenance of
  certification if:
               (1)  the entity's designation under law or
  certification or accreditation by a national certifying or
  accrediting organization is contingent on the entity requiring a
  specific maintenance of certification by physicians seeking staff
  privileges or credentialing at the entity; and
               (2)  the differentiation is limited to those physicians
  whose maintenance of certification is required for the entity's
  designation, certification, or accreditation as described by
  Subdivision (1).
         (c)  An entity described by Subsection (a) may differentiate
  between physicians based on a physician's maintenance of
  certification if the voting physician members of the entity's
  organized medical staff vote to authorize the differentiation.
         (d)  An authorization described by Subsection (c) may:
               (1)  be made only by the voting physician members of the
  entity's organized medical staff and not by the entity's governing
  body, administration, or any other person;
               (2)  subject to Subsection (e), establish terms
  applicable to the entity's differentiation, including:
                     (A)  appropriate grandfathering provisions; and
                     (B)  limiting the differentiation to certain
  medical specialties; and
               (3)  be rescinded at any time by a vote of the voting
  physician members of the entity's organized medical staff.
         (e)  Terms established under Subsection (d)(2) may not
  conflict with a maintenance of certification requirement
  applicable to the entity's designation under law or certification
  or accreditation by a national certifying or accrediting
  organization.
         SECTION 4.  Section 155.003, Occupations Code, is amended by
  amending Subsection (d) and adding Subsection (d-1) to read as
  follows:
         (d)  Except as provided by Subsection (d-1), in [In] addition
  to the other requirements prescribed by this subtitle, the board
  may require an applicant to comply with other requirements that the
  board considers appropriate.
         (d-1)  The board may not require maintenance of
  certification by an applicant for the applicant to be eligible for a
  license under this chapter.
         SECTION 5.  Section 156.001, Occupations Code, is amended by
  adding Subsection (f) to read as follows:
         (f)  The board may not adopt a rule requiring maintenance of
  certification by a license holder for the license holder to be
  eligible for an initial or renewal registration permit.
         SECTION 6.  This Act takes effect January 1, 2018.
 
 
 
 
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
         I hereby certify that S.B. No. 1148 passed the Senate on
  April 27, 2017, by the following vote:  Yeas 31, Nays 0;
  May 25, 2017, Senate refused to concur in House amendments and
  requested appointment of Conference Committee; May 26, 2017, House
  granted request of the Senate; May 28, 2017, Senate adopted
  Conference Committee Report by the following vote:  Yeas 30,
  Nays 1.
 
 
  ______________________________
  Secretary of the Senate    
 
         I hereby certify that S.B. No. 1148 passed the House, with
  amendments, on May 24, 2017, by the following vote:  Yeas 140,
  Nays 4, one present not voting; May 26, 2017, House granted request
  of the Senate for appointment of Conference Committee;
  May 28, 2017, House adopted Conference Committee Report by the
  following vote:  Yeas 144, Nays 2, two present not voting.
 
 
  ______________________________
  Chief Clerk of the House   
 
 
 
  Approved:
 
  ______________________________ 
             Date
 
 
  ______________________________ 
            Governor