HB3588 - Relating to patients' rights, consumer protection, and directives for the provision of health care services; providing an administrative penalty.

  89R13710 EAS-F     By: Campos H.B. No. 3588       A BILL TO BE ENTITLED   AN ACT   relating to patients' rights, consumer protection, and directives   for the provision of health care services; providing an   administrative penalty.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Subchapter A, Chapter 166, Health and Safety   Code, is amended by adding Section 166.012 to read as follows:           Sec.   166.012.     DIRECTIVE FOR PHYSICIAN DIAGNOSIS AND   TREATMENT. (a)   A competent adult may execute a written directive   that:                 (1)     requires any diagnosis or treatment provided to   the adult to be provided only by a physician; and                 (2)     provides that if the adult is incompetent or   otherwise mentally or physically incapable of communication, only a   physician may diagnose and treat the adult.           (b)     Except as provided by Subsection (c), the declarant must   sign the directive in the presence of two witnesses who qualify   under Section 166.003, at least one of whom must be a witness who   qualifies under Section 166.003(2).   The witnesses must sign the   directive.           (c)     The declarant, in lieu of signing in the presence of   witnesses, may sign the directive and have the signature   acknowledged before a notary public.           (d)     A declarant shall notify the declarant's attending   physician of the existence of the written directive.   If the   declarant is incompetent or otherwise mentally or physically   incapable of communication, another person may notify the attending   physician of the existence of the directive.   The attending   physician shall make the directive a part of the declarant's   medical record.           (e)     A directive described by Subsection (a) prevails over a   conflicting directive unless the conflicting directive is later   executed and states that the directive executed under this section   is revoked.          SECTION 2.  Title 2, Health and Safety Code, is amended by   adding Subtitle K to read as follows:   SUBTITLE K.   PROVISION OF HEALTH CARE SERVICES   CHAPTER 189.   TEXAS PATIENTS' BILL OF RIGHTS   SUBCHAPTER A.   GENERAL PROVISIONS           Sec. 189.001.  DEFINITIONS. In this chapter:                 (1)     "Health care facility" means a facility licensed,   certified, registered, or otherwise authorized to administer   health care services, for profit or otherwise, to individuals in   this state in the ordinary course of business or professional   practice.                 (2)     "Health care practitioner" means an individual   licensed, certified, registered, or otherwise authorized to   administer health care services, for profit or otherwise, to   individuals in this state in the ordinary course of business or   practice.                 (3)     "Health care services" means services provided by   a health care practitioner to prevent, alleviate, cure, or heal   human illness or injury.           Sec.   189.002.     PURPOSE. The purpose of this chapter is to   provide the necessary information for patients to make informed   decisions on health care services.           Sec.   189.003.     APPLICABILITY. (a)   Except as provided by   Subsection (b), this chapter applies to each health care facility   in this state, including hospitals, freestanding emergency medical   care facilities, hospital-owned outpatient clinics, urgent care   centers, and ambulatory surgical centers, and each health care   practitioner in this state.           (b)     This chapter does not apply to a dentist, physical   therapist, or chiropractor.             Sec.   189.004.     RULES. Each state regulatory agency that   issues a license, certification, registration, or other   authorization to a health care facility or health care   practitioner, including the Texas Medical Board, Texas Physician   Assistant Board, and Texas Board of Nursing, and the executive   commissioner shall adopt rules necessary to implement this chapter.   SUBCHAPTER B.   PATIENT RIGHTS           Sec.   189.051.     RIGHTS RELATED TO HEALTH CARE PRACTITIONERS.   A patient in this state has the right to:                 (1)     be informed of the type of license a health care   practitioner holds by viewing a photo identification worn by the   practitioner in accordance with Section 189.102;                 (2)     be informed about whether a supervising physician   is present at the health care facility at the time the patient   receives health care services at the facility;                 (3)     decline health care services provided by a   nonphysician health care practitioner and instead request that a   physician provide the health care services within a reasonable   time;                 (4)     be informed in advance of the patient's health care   appointment of the health care practitioner scheduled to provide   health care services to the patient;                 (5)     avoid any penalty for the patient's refusal to   accept provision of health care services by a nonphysician health   care practitioner;                 (6)     be provided an initial consultation only with a   specialist who is a physician;                 (7)     be informed of the identity of the physician   supervising each nonphysician health care practitioner involved in   providing health care services to the patient; and                 (8)     be provided accurate health care information that   is not misleading or deceptive in a manner prohibited under Section   102.0015, Occupations Code.           Sec.   189.052.     RIGHTS RELATED TO INFORMED CONSENT. (a)   A   patient in this state has the right to:                 (1)     receive a clearly readable and intelligible copy   of all consent to treat forms before the patient is asked to sign   those forms;                 (2)     receive and execute a one-page document   authorizing only a physician to diagnose and treat the patient;                 (3)     receive simplified paperwork that does not require   the patient to enter duplicate information on multiple forms;                 (4)     execute an advance directive under Section 166.012   requiring that only a physician diagnose and treat the patient,   including when the patient is unable to communicate; and                 (5)     receive documentation with a clear explanation of   each proposed health care service, including medications, and any   practicable alternatives to each service.           (b)     A reference on an electronic device to a consent to   treat form or another document that the patient has not received   does not satisfy the requirements of Subsection (a)(1).           Sec.   189.053.     RIGHTS RELATED TO TREATMENT. A patient in   this state has the right to:                 (1)     if practicable, have an advocate, including a   family member or other individual, present with the patient during   the provision of health care services;                 (2)     receive an easily understandable summary of the   health care services provided to the patient;                 (3)     for hospitalized patients, have an accurate active   medication list maintained at all times while the patient remains   hospitalized; and                 (4)     as applicable, receive documentation stating that   the patient's treatment is deviating from the standard of care   because of cost, health benefit plan coverage, or hospital supply   shortage.             Sec.   189.054.     RIGHTS RELATED TO BILLING. A patient in this   state has the right to receive:                 (1)     if practicable, a written estimate of the cost of   health care services, including the cost of directly paying the   health care practitioner or health care facility that provides the   services rather than paying through a health benefit plan;                 (2)     written notice on whether the patient's health   benefit plan covers a health care service;                 (3)     a written disclosure on whether any health care   practitioner who may provide health care services to the patient is   an independent contractor who bills separately; and                 (4)     a reduced price for health care services provided   by a nonphysician health care practitioner.   SUBCHAPTER C.   REQUIREMENTS FOR HEALTH CARE FACILITIES AND   PRACTITIONERS           Sec.   189.101.     PROHIBITED ABRIDGEMENT OF RIGHTS OR VIOLATION   OF RULES. A health care facility or health care practitioner may   not abridge a right described by Subchapter B or violate a rule   adopted under this chapter.           Sec.   189.102.     PHOTO IDENTIFICATION REQUIREMENTS FOR HEALTH   CARE PRACTITIONERS. (a)   While providing health care services to a   patient, a health care practitioner shall wear a clearly visible   photo identification that identifies the practitioner's   occupational license, certification, registration, or other   authorization issued under Title 3, Occupations Code, or the   occupational license, certification, registration, or other   authorization for which the practitioner is training under that   title.             (b)     The photo identification must clearly state the health   care practitioner's occupation and may not abbreviate the   occupation.           (c)     The photo identification for a health care practitioner   who is training to hold a license, certification, registration, or   other authorization under Title 3, Occupations Code, must identify   the practitioner as a student, resident, or fellow.           Sec.   189.103.     INFORMATION REGARDING NONPHYSICIAN HEALTH   CARE PRACTITIONERS. A health care facility employing nonphysician   health care practitioners at a facility location shall clearly post   in each patient waiting area at the location and on all   advertisements for health care services provided at the location   that:                 (1)     health care services are provided by nonphysician   health care practitioners; and                 (2)     the patient has the right to be informed of the   identity of the supervising physician of any nonphysician health   care provider who provides health care services to the patient.           Sec.   189.104.     PROVISION OF TRAINING INFORMATION. A health   care facility in this state shall post the differences in training   requirements for the health care practitioners employed by the   facility on the facility's Internet website and in each of the   facility's patient waiting areas.   SUBCHAPTER D.   ENFORCEMENT           Sec.   189.151.     REPORT. A patient may report a violation of a   right described by Subchapt [Text truncated for display. Full text available on Congress.gov.]