Campos Patients’ Rights Bill Exempts Dentists, Physical Therapists And Chiropractors

The text as introduced · 1,914 words

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 Subchapter B to:

(1) the state regulatory agency that issues a license,

certification, registration, or other authorization to a health

care practitioner, including:

(A) the Texas Medical Board for physicians;

(B) the Texas Physician Assistant Board for

physician assistants; and

(C) the Texas Board of Nursing for nurses; and

(2) the state regulatory agency that issues a license,

certification, registration, or other authorization to a health

care facility, including the commission.

Sec. 189.152. ADMINISTRATIVE PENALTY. (a) A state

regulatory agency for a health care facility or health care

practitioner, including the Texas Medical Board, the Texas

Physician Assistant Board, the Texas Board of Nursing, and the

commission, may impose an administrative penalty against a person

regulated by the agency who violates this chapter or a rule adopted

under this chapter.

(b) The assessed penalty may not be less than $100 or more

than $10,000 for each violation. Each day of a violation that

occurs before the day on which the person receives written notice of

the violation does not constitute a separate violation and shall be

considered one violation. Each day of a continuing violation that

occurs after the day on which the person receives written notice of

the violation constitutes a separate violation.

SECTION 3. Subchapter A, Chapter 102, Occupations Code, is

amended by adding Section 102.0015 to read as follows:

Sec. 102.0015. REQUIREMENTS AND PROHIBITED PRACTICES

RELATED TO QUALIFICATIONS IN ADVERTISEMENTS. (a) A person may not

make a deceptive or misleading statement or engage in a deceptive or

misleading act in advertising health care services that

misrepresents:

(1) whether the person holds a license, certification,

registration, or other authorization issued by this state to

provide the services; or

(2) the person's education, training, or clinical

expertise.

(b) A person who is advertising health care services

provided by the person shall disclose in the advertisement the

applicable license, certification, registration, or other

authorization under which the person is authorized to provide the

services.

SECTION 4. Section 102.008, Occupations Code, is amended to

read as follows:

Sec. 102.008. DISCIPLINARY ACTION. A violation of Section

102.001 , 102.0015, or 102.006 is grounds for disciplinary action by

the regulatory agency that issued a license, certification, or

registration to the person who committed the violation.

SECTION 5. Each state regulatory agency that issues a

license, certification, registration, or other authorization to a

health care practitioner or health care facility, including the

Texas Medical Board, Texas Physician Assistant Board, and Texas

Board of Nursing, and the executive commissioner of the Health and

Human Services Commission shall adopt rules necessary to implement

Chapter 189, Health and Safety Code, as added by this Act, not later

than January 1, 2026.

SECTION 6. Chapter 189, Health and Safety Code, as added by

this Act, applies to the provision of health care services on or

after January 1, 2026.

SECTION 7. This Act takes effect September 1, 2025.