reglab/statecodes huggingface dataset:
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 312 - Medical and Dental Clinical Education in Public Hospitals › Section 312.006. Limitation on Liability

Sec. 312.006.  LIMITATION ON LIABILITY.  (a)  A medical and dental unit, supported medical or dental school, or coordinating entity engaged in coordinated or cooperative medical or dental clinical education under Section 312.004, including patient care and the provision or performance of health or dental services or research at a public hospital, is not liable for its acts and omissions in connection with those activities except to the extent and up to the maximum amount of liability of state government under Section 101.023(a), Civil Practice and Remedies Code, for the acts and omissions of a governmental unit of state government under Chapter 101, Civil Practice and Remedies Code.
(b)  The limitation on liability provided by this section applies regardless of whether the medical and dental unit, supported medical or dental school, or coordinating entity is a "governmental unit" as defined by Section 101.001, Civil Practice and Remedies Code.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 312 - Medical and Dental Clinical Education in Public Hospitals › Section 312.007. Individual Liability

Sec. 312.007.  INDIVIDUAL LIABILITY.  (a)  A medical and dental unit, supported medical or dental school, or coordinating entity is a state agency, and a director, trustee, officer, intern, resident, fellow, faculty member, or other associated health care professional or employee of a medical and dental unit, supported medical or dental school, or coordinating entity is an employee of a state agency for purposes of Chapter 104, Civil Practice and Remedies Code, and for purposes of determining the liability, if any, of the person for the person's acts or omissions while engaged in the coordinated or cooperative activities of the unit, school, or entity.
(b)  A judgment in an action or settlement of a claim against a medical and dental unit, supported medical or dental school, or coordinating entity under Chapter 101, Civil Practice and Remedies Code, bars any action involving the same subject matter by the claimant against a director, trustee, officer, intern, resident, fellow, faculty member, or other associated health care professional or employee of the unit, school, or entity whose act or omission gave rise to the claim as if the person were an employee of a governmental unit against which the claim was asserted as provided under Section 101.106, Civil Practice and Remedies Code.
(c)  A resident engaged in graduate medical education in a public or nonprofit hospital in association with a medical and dental unit is an employee of a state agency regardless of whether the resident receives a stipend or other payment from the medical and dental unit for services performed as a resident.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Amended by:
Acts 2017, 85th Leg., R.S., Ch. 726 (S.B. 1066), Sec. 3, eff. June 12, 2017.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 313 - Consent to Medical Treatment Act › Section 313.001. Short Title

Sec. 313.001.  SHORT TITLE.  This chapter may be cited as the Consent to Medical Treatment Act.
Added by Acts 1993, 73rd Leg., ch. 407, Sec. 1, eff. Sept. 1, 1993.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 313 - Consent to Medical Treatment Act › Section 313.002. Definitions

Sec. 313.002.  DEFINITIONS.  In this chapter:
(1)  "Adult" means a person 18 years of age or older or a person under 18 years of age who has had the disabilities of minority removed.
(2)  "Attending physician" means the physician with primary responsibility for a patient's treatment and care.
(3)  "Decision-making capacity" means the ability to understand and appreciate the nature and consequences of a decision regarding medical treatment and the ability to reach an informed decision in the matter.
(3-a)  "Home and community support services agency" means a facility licensed under Chapter 142.
(4)  "Hospital" means a facility licensed under Chapter 241.
(5)  "Incapacitated" means lacking the ability, based on reasonable medical judgment, to understand and appreciate the nature and consequences of a treatment decision, including the significant benefits and harms of and reasonable alternatives to any proposed treatment decision.
(6)  "Medical treatment" means a health care treatment, service, or procedure designed to maintain or treat a patient's physical or mental condition, as well as preventative care.
(7)  "Nursing home" means a facility licensed under Chapter 242.
(8)  "Patient" means a person who:
(A)  is admitted to a hospital;
(B)  is residing in a nursing home;
(C)  is receiving services from a home and community support services agency; or
(D)  is an inmate of a county or municipal jail.
(9)  "Physician" means:
(A)  a physician licensed by the Texas State Board of Medical Examiners;  or
(B)  a physician with proper credentials who holds a commission in a branch of the armed services of the United States and who is serving on active duty in this state.
(10)  "Surrogate decision-maker" means an individual with decision-making capacity who is identified as the person who has authority to consent to medical treatment on behalf of an incapacitated patient in need of medical treatment.
Added by Acts 1993, 73rd Leg., ch. 407, Sec. 1, eff. Sept. 1, 1993.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 1271 (H.B. 3473), Sec. 1, eff. September 1, 2007.
Acts 2011, 82nd Leg., R.S., Ch. 253 (H.B. 1128), Sec. 1, eff. September 1, 2011.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 313 - Consent to Medical Treatment Act › Section 313.003. Exceptions and Application

Sec. 313.003.  EXCEPTIONS AND APPLICATION.  (a)  This chapter does not apply to:
(1)  a decision to withhold or withdraw life-sustaining treatment from qualified terminal or irreversible patients under Subchapter B, Chapter 166;
(2)  a health care decision made under a medical power of attorney under Subchapter D, Chapter 166, or under Subtitle P, Title 2, Estates Code;
(3)  consent to medical treatment of minors under Chapter 32, Family Code;
(4)  consent for emergency care under Chapter 773;
(5)  hospital patient transfers under Chapter 241; or
(6)  a patient's legal guardian who has the authority to make a decision regarding the patient's medical treatment.
(b)  This chapter does not authorize a decision to withhold or withdraw life-sustaining treatment.
Added by Acts 1993, 73rd Leg., ch. 407, Sec. 1, eff. Sept. 1, 1993.  Amended by Acts 1999, 76th Leg., ch. 450, Sec. 2.01, eff. Sept. 1, 1999.
Amended by:
Acts 2017, 85th Leg., R.S., Ch. 324 (S.B. 1488), Sec. 22.045, eff. September 1, 2017.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 313 - Consent to Medical Treatment Act › Section 313.005. Prerequisites for Consent

Sec. 313.005.  PREREQUISITES FOR CONSENT.  (a)  If an adult patient of a home and community support services agency or in a hospital or nursing home, or an adult inmate of a county or municipal jail, is comatose, incapacitated, or otherwise mentally or physically incapable of communication and, according to reasonable medical judgment, is in need of medical treatment, the attending physician shall describe the:
(1)  patient's comatose state, incapacity, or other mental or physical inability to communicate in the patient's medical record; and
(2)  proposed medical treatment in the patient's medical record.
(b)  The attending physician shall make a reasonably diligent effort to contact or cause to be contacted the persons eligible to serve as surrogate decision-makers.  Efforts to contact those persons shall be recorded in detail in the patient's medical record.
(c)  If a surrogate decision-maker consents to medical treatment on behalf of the patient, the attending physician shall record the date and time of the consent and sign the patient's medical record.  The surrogate decision-maker shall countersign the patient's medical record or execute an informed consent form.
(d)  A surrogate decision-maker's consent to medical treatment that is not made in person shall be reduced to writing in the patient's medical record, signed by the home and community support services agency, hospital, or nursing home staff member receiving the consent, and countersigned in the patient's medical record or on an informed consent form by the surrogate decision-maker as soon as possible.
Added by Acts 1993, 73rd Leg., ch. 407, Sec. 1, eff. Sept. 1, 1993.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 1271 (H.B. 3473), Sec. 3, eff. September 1, 2007.
Acts 2011, 82nd Leg., R.S., Ch. 253 (H.B. 1128), Sec. 3, eff. September 1, 2011.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 313 - Consent to Medical Treatment Act › Section 313.006. Liability for Medical Treatment Costs

Sec. 313.006.  LIABILITY FOR MEDICAL TREATMENT COSTS.  Liability for the cost of medical treatment provided as a result of consent to medical treatment by a surrogate decision-maker is the same as the liability for that cost if the medical treatment were provided as a result of the patient's own consent to the treatment.
Added by Acts 1993, 73rd Leg., ch. 407, Sec. 1, eff. Sept. 1, 1993.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 313 - Consent to Medical Treatment Act › Section 313.007. Limitation on Liability

Sec. 313.007.  LIMITATION ON LIABILITY.  (a)  A surrogate decision-maker is not subject to criminal or civil liability for consenting to medical care under this chapter if the consent is made in good faith.
(b)  An attending physician, home and community support services agency, hospital, or nursing home or a person acting as an agent for or under the control of the physician, home and community support services agency, hospital, or nursing home is not subject to criminal or civil liability and has not engaged in unprofessional conduct if the medical treatment consented to under this chapter:
(1)  is done in good faith under the consent to medical treatment;  and
(2)  does not constitute a failure to exercise due care in the provision of the medical treatment.
Added by Acts 1993, 73rd Leg., ch. 407, Sec. 1, eff. Sept. 1, 1993.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 1271 (H.B. 3473), Sec. 4, eff. September 1, 2007.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314 - Cooperative Agreements Among Hospitals › Section 314.001. Definitions

Sec. 314.001.  DEFINITIONS.  In this chapter:
(1)  "Attorney general" means the attorney general of Texas or any assistant attorney general acting under the direction of the attorney general of Texas.
(2)  "Cooperative agreement" means an agreement among two or more hospitals for the allocation or sharing of health care equipment, facilities, personnel, or services.
(3)  "Department" means the Department of State Health Services.
(3-a)  "Executive commissioner" means the executive commissioner of the Health and Human Services Commission.
(4)  "Hospital" means a general or special hospital licensed under Chapter 241 or a private mental hospital licensed under Chapter 577.
Added by Acts 1993, 73rd Leg., ch. 638, Sec. 1, eff. Sept. 1, 1993.  Renumbered from Health & Safety Code Sec. 313.001 by Acts 1995, 74th Leg., ch. 76, Sec. 17.01(25), eff. Sept. 1, 1995.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0851, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314 - Cooperative Agreements Among Hospitals › Section 314.004. Monitoring of Approved Cooperative Agreements

Sec. 314.004.  MONITORING OF APPROVED COOPERATIVE AGREEMENTS.  (a)  If, at any time following the approval of a cooperative agreement by the department, the department determines that as a result of changed circumstances the benefits resulting from an approved agreement no longer outweigh any disadvantages attributable to a reduction in competition resulting from the agreement, the department may initiate proceedings to terminate the certificate of public advantage.
(b)  The department may request documents from the parties to the cooperative agreement regarding the current status of the agreement, including information relative to the continued benefits and any disadvantages of the agreement and shall, if requested, hold a public hearing to solicit additional information concerning the effects of the cooperative agreement.
(c)  If the department determines that the likely benefits resulting from an approved cooperative agreement no longer outweigh any disadvantages attributable to any potential reduction in competition resulting from the agreement, the department may terminate the certificate of public advantage.
Added by Acts 1993, 73rd Leg., ch. 638, Sec. 1, eff. Sept. 1, 1993.  Renumbered from Health & Safety Code Sec. 313.004 by Acts 1995, 74th Leg., ch. 76, Sec. 17.01(25), eff. Sept. 1, 1995.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314 - Cooperative Agreements Among Hospitals › Section 314.005. Judicial Review of Department Action

Sec. 314.005.  JUDICIAL REVIEW OF DEPARTMENT ACTION.  Any party aggrieved by a decision of the department in granting or denying an application, refusing to act on an application, or terminating a certificate is entitled to judicial review of the decision in accordance with Chapter 2001, Government Code.
Added by Acts 1993, 73rd Leg., ch. 638, Sec. 1, eff. Sept. 1, 1993.  Amended by Acts 1995, 74th Leg., ch. 76, Sec. 5.95(49), eff. Sept. 1, 1995.  Renumbered by Health & Safety Code Sec. 313.005 by Acts 1995, 74th Leg., ch. 76, Sec. 17.01(25), eff. Sept. 1, 1995.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314 - Cooperative Agreements Among Hospitals › Section 314.006. Validity of Certified Cooperative Agreements

Sec. 314.006.  VALIDITY OF CERTIFIED COOPERATIVE AGREEMENTS.  (a)  Notwithstanding Section 15.05(a), Business & Commerce Code, or any other provision of law, a cooperative agreement for which a certificate of public advantage has been issued is a lawful agreement.  Notwithstanding Section 15.05(a), Business & Commerce Code, or any other provision of law, if the parties to a cooperative agreement file an application for a certificate of public advantage governing the agreement with the department, the conduct of the parties in negotiating and entering into a cooperative agreement is lawful conduct.
(b)  If the department, or in any action by the attorney general the district court, determines that the applicants have not established by clear and convincing evidence that the likely benefits resulting from a cooperative agreement outweigh any disadvantages attributable to any potential reduction in competition resulting from the agreement, the agreement is invalid and has no further force or effect.
(c)  Nothing in this chapter exempts hospitals from compliance with the requirements of Chapters 241 or 577 of this code.
Added by Acts 1993, 73rd Leg., ch. 638, Sec. 1, eff. Sept. 1, 1993.  Renumbered from Health & Safety Code Sec. 313.006 by Acts 1995, 74th Leg., ch. 76, Sec. 17.01(25), eff. Sept. 1, 1995.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314 - Cooperative Agreements Among Hospitals › Section 314.007. Mergers and Consolidations Involving Hospitals

Sec. 314.007.  MERGERS AND CONSOLIDATIONS INVOLVING HOSPITALS.  The provisions of this chapter do not apply to any agreement among hospitals by which ownership or control over substantially all of the stock, assets of activities of one or more previously licensed and operating hospitals is placed under the control of another licensed hospital or hospitals.
Added by Acts 1993, 73rd Leg., ch. 638, Sec. 1, eff. Sept. 1, 1993.  Renumbered from Health & Safety Code Sec. 313.007 by Acts 1995, 74th Leg., ch. 76, Sec. 17.01(25), eff. Sept. 1, 1995.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314 - Cooperative Agreements Among Hospitals › Section 314.008. Exclusions; Authority to Adopt Rules

Sec. 314.008.  EXCLUSIONS; AUTHORITY TO ADOPT RULES.  (a)  This chapter specifically excludes ground and/or air ambulance services.
(b)  The executive commissioner shall have the authority to adopt rules to implement the requirements of this chapter.
Added by Acts 1993, 73rd Leg., ch. 638, Sec. 1, eff. Sept. 1, 1993.  Renumbered from Health & Safety Code Sec. 313.008 by Acts 1995, 74th Leg., ch. 76, Sec. 17.01(25), eff. Sept. 1, 1995.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0853, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter A. General Provisions › Section 314A.001. Definitions

Sec. 314A.001.  DEFINITIONS.  In this chapter:
(1)  "Attorney general" means the attorney general of Texas or any assistant attorney general acting under the direction of the attorney general of Texas.
(2)  "Designated agency" means the state agency designated by the governor under Section 314A.004.
(3)  "Hospital" means a nonpublic general hospital that is licensed under Chapter 241 and is not maintained or operated by a political subdivision of this state.
(4)  "Merger agreement" or "merger" means an agreement among two or more hospitals for the consolidation by merger or other acquisition or transfer of assets by which ownership or control over substantially all of the stock, assets, or activities of one or more previously licensed and operating hospitals is placed under the control of another licensed hospital or hospitals or another entity that controls the hospitals.
(5)  "State agency" means a department, commission, board, office, or other agency in the executive branch of state government that is created by the constitution or a statute of this state.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter A. General Provisions › Section 314A.002. Applicability

Sec. 314A.002.  APPLICABILITY.  This chapter applies only to a merger agreement among hospitals each of which is located within a county that:
(1)  contains two or more hospitals; and
(2)  has a population of:
(A)  less than 100,000 and is not adjacent to a county with a population of 250,000 or more; or
(B)  more than 100,000 and less than 150,000 and is not adjacent to a county with a population of 100,000 or more.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter A. General Provisions › Section 314A.003. Legislative Findings and Purposes; Grant of Antitrust Immunity

Sec. 314A.003.  LEGISLATIVE FINDINGS AND PURPOSES; GRANT OF ANTITRUST IMMUNITY.  (a)  The legislature finds that:
(1)  a merger among hospitals may benefit the public by maintaining or improving the quality, efficiency, and accessibility of health care services offered to the public; and
(2)  the benefits described by Subdivision (1) resulting from the merger may outweigh any anticompetitive effects of joining together competitors to address unique challenges in providing health care services in rural areas.
(b)  The legislature believes it is in the state's best interest to supplant state and federal antitrust laws with a process for regulatory approval and active supervision by the designated agency as provided by this chapter.  It is the intent of the legislature that this chapter immunize from all federal and state antitrust laws the execution of merger agreements approved under this chapter and post-merger activities supervised under this chapter.
(c)  Nothing in this chapter affects antitrust immunity that may be provided through another provision of state law.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter A. General Provisions › Section 314A.004. Designation of Supervising State Agency

Sec. 314A.004.  DESIGNATION OF SUPERVISING STATE AGENCY.  (a)  The governor shall designate an appropriate state agency, other than the office of the attorney general, to:
(1)  review and approve or deny applications submitted under this chapter for certificates of public advantage; and
(2)  supervise as provided by Subchapter C the activities for which a certificate of public advantage is issued.
(b)  After the governor designates a state agency under Subsection (a), the governor may designate another appropriate state agency under that subsection at any time.
(c)  A change in the designation of a state agency made under this section does not affect the validity of any action taken under this chapter by a predecessor designated agency.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter A. General Provisions › Section 314A.005. Rulemaking

Sec. 314A.005.  RULEMAKING.  The designated agency shall adopt rules for the administration and implementation of this chapter.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter B. Certificate of Public Advantage › Section 314A.051. Review and Certification of Merger Agreements Required

Sec. 314A.051.  REVIEW AND CERTIFICATION OF MERGER AGREEMENTS REQUIRED.  (a)  Two or more hospitals may negotiate and enter into a merger agreement, subject to approval by the designated agency as provided by this subchapter.
(b)  No merger agreement shall receive immunity under this chapter unless the designated agency issues a certificate of public advantage governing the merger agreement.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter B. Certificate of Public Advantage › Section 314A.052. Application

Sec. 314A.052.  APPLICATION.  (a)  One or more parties to a merger agreement may submit an application to the designated agency for a certificate of public advantage governing the merger agreement.  The application must include a written copy of the merger agreement and describe the nature and scope of the merger.
(b)  If an applicant believes the documents or other information required to be submitted with an application under Subsection (a) contains proprietary information that is required to remain confidential, the applicant shall:
(1)  clearly identify the information; and
(2)  submit duplicate applications, one application that has complete information for the designated agency's use and one redacted application that will be made available for public release.
(c)  A copy of the application and copies of all additional related materials must be submitted to the attorney general and to the designated agency at the same time.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter B. Certificate of Public Advantage › Section 314A.053. Application Fee

Sec. 314A.053.  APPLICATION FEE.  (a)  The designated agency may assess a fee for filing an application under Section 314A.052 in an amount not to exceed $75,000.  The amount of the fee must be sufficient to cover the reasonable costs of the designated agency and attorney general in reviewing and approving or denying applications under this subchapter.
(b)  Fees collected under this section may be appropriated to the designated agency for purposes of covering costs relating to the implementation and administration of this chapter, including the supervision of hospitals under this chapter.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter B. Certificate of Public Advantage › Section 314A.054. Review of Application by Designated Agency; Grant or Denial of Application

Sec. 314A.054.  REVIEW OF APPLICATION BY DESIGNATED AGENCY; GRANT OR DENIAL OF APPLICATION.  (a)  The designated agency shall review an application for a certificate of public advantage in accordance with the standard prescribed by Section 314A.056(a)(1).
(b)  The designated agency shall grant or deny the application not later than the 120th day after the date of the filing of the application.  The designated agency's decision must:
(1)  be in writing;
(2)  specify the basis for the decision; and
(3)  provide a copy of the decision to the applicants on the date of the decision.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter B. Certificate of Public Advantage › Section 314A.055. Review of Application by Attorney General

Sec. 314A.055.  REVIEW OF APPLICATION BY ATTORNEY GENERAL.  (a)  The attorney general shall review an application for a certificate of public advantage and all supporting documents and information provided by the applicants.  On completion of the review and subject to Subsection (b), the attorney general shall advise the designated agency whether:
(1)  the proposed merger agreement would likely benefit the public by maintaining or improving the quality, efficiency, and accessibility of health care services offered to the public; and
(2)  the likely benefits resulting from the proposed merger agreement outweigh any disadvantages attributable to a reduction in competition that may result from the proposed merger.
(b)  The attorney general shall review an application for a certificate of public advantage as soon as practicable, taking into consideration the deadline prescribed by Section 314A.054.
(c)  If the attorney general advises the designated agency to deny an application, the attorney general shall state the basis and reasons for the recommended denial.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter B. Certificate of Public Advantage › Section 314A.056. Issuance of Certificate of Public Advantage

Sec. 314A.056.  ISSUANCE OF CERTIFICATE OF PUBLIC ADVANTAGE.  (a)  The designated agency, after reviewing the application and consulting with the attorney general in accordance with Section 314A.055, shall issue a certificate of public advantage for a merger agreement if:
(1)  the designated agency determines under the totality of the circumstances that:
(A)  the proposed merger would likely benefit the public by maintaining or improving the quality, efficiency, and accessibility of health care services offered to the public; and
(B)  the likely benefits resulting from the proposed merger agreement described by Paragraph (A) outweigh any disadvantages attributable to a reduction in competition that may result from the proposed merger; and
(2)  the application:
(A)  provides specific evidence showing that the proposed merger would likely benefit the public as described by Subdivision (1)(A);
(B)  explains in detail how the likely benefits resulting from the proposed merger agreement outweigh any disadvantages attributable to a reduction in competition as described by Subdivision (1)(B); and
(C)  sufficiently addresses the factors listed in Subsection (b) and any other factor the designated agency may require based on the circumstances specific to the application.
(b)  In making the determination under Subsection (a)(1), the designated agency shall consider the effect of the merger agreement on the following nonexclusive list of factors:
(1)  the quality and price of hospital and health care services provided to citizens of this state;
(2)  the preservation of sufficient hospitals within a geographic area to ensure public access to acute care;
(3)  the cost efficiency of services, resources, and equipment provided or used by the hospitals that are a party to the merger agreement;
(4)  the ability of health care payors to negotiate payment and service arrangements with hospitals proposed to be merged under the agreement; and
(5)  the extent of any reduction in competition among physicians, allied health professionals, other health care providers, or other persons providing goods or services to, or in competition with, hospitals.
(c)  The designated agency may include terms or conditions of compliance in connection with a certificate of public advantage issued under this subchapter if necessary to ensure that the proposed merger likely benefits the public as specified in Subsection (a)(1).
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter B. Certificate of Public Advantage › Section 314A.057. Records

Sec. 314A.057.  RECORDS.  The designated agency shall maintain records of all merger agreements the designated agency has approved under this chapter, including any terms or conditions of issuing a certificate of public advantage that are imposed by the designated agency.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter B. Certificate of Public Advantage › Section 314A.058. Termination of Certificate of Public Advantage by Hospital

Sec. 314A.058.  TERMINATION OF CERTIFICATE OF PUBLIC ADVANTAGE BY HOSPITAL.  A hospital resulting from a merger agreement approved under this chapter may voluntarily terminate its certificate of public advantage by giving the designated agency notice at least 30 days before the date of the termination.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter B. Certificate of Public Advantage › Section 314A.059. Annual Review of Certificate

Sec. 314A.059.  ANNUAL REVIEW OF CERTIFICATE.  (a)  The designated agency shall annually review an approved certificate of public advantage.
(b)  The attorney general may annually review an approved certificate of public advantage.
(c)  The designated agency may not complete its annual review of an approved certificate of public advantage under this section until:
(1)  the attorney general informs the designated agency whether the attorney general intends to conduct any review of the certificate of public advantage as authorized under this section; and
(2)  if the attorney general informs the designated agency of the attorney general's intent to conduct a review of an entity's approved certificate of public advantage, the attorney general has had the opportunity to conduct the review.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter C. Supervision of Merged Hospitals Under Approved Merger Agreement › Section 314A.101. Supervision of Merged Hospitals

Sec. 314A.101.  SUPERVISION OF MERGED HOSPITALS.  The designated agency shall supervise in the manner provided by this subchapter each hospital operating under a certificate of public advantage issued under this chapter to ensure that the immunized conduct of a merged entity furthers the purposes of this chapter.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter C. Supervision of Merged Hospitals Under Approved Merger Agreement › Section 314A.103. Annual Report

Sec. 314A.103.  ANNUAL REPORT.  Each hospital operating under a certificate of public advantage shall submit an annual report to the designated agency.  The report must include:
(1)  information about the extent of the benefits attributable to the issuance of the certificate of public advantage;
(2)  if applicable, information about the hospital's actions taken:
(A)  in furtherance of any commitments made by the parties to the merger; or
(B)  to comply with terms imposed by the designated agency as a condition for approval of the merger agreement;
(3)  a description of the activities conducted by the hospital under the merger agreement;
(4)  information relating to the price, cost, and quality of and access to health care for the population served by the hospital; and
(5)  any other information required by the designated agency to ensure compliance with this chapter, including information relating to compliance with any terms or conditions for issuance of the certificate of public advantage.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter C. Supervision of Merged Hospitals Under Approved Merger Agreement › Section 314A.104. Corrective Action Plan

Sec. 314A.104.  CORRECTIVE ACTION PLAN.  (a)  The designated agency shall require a hospital operating under a certificate of public advantage to adopt a plan to correct a deficiency in the hospital's activities if the designated agency determines that an activity of the hospital:
(1)  does not benefit the public as described by Section 314A.056(a)(1)(A); or
(2)  no longer meets the standard prescribed by Section 314A.056(a)(1).
(b)  The corrective action plan must include each provision required by the designated agency and must be submitted at the agency's direction.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter C. Supervision of Merged Hospitals Under Approved Merger Agreement › Section 314A.105. Supervision Fee

Sec. 314A.105.  SUPERVISION FEE.  (a)  The designated agency may assess an annual supervision fee in an amount that is at least $75,000 but not more than $200,000 against each hospital operating under a certificate of public advantage under this chapter.  The amount of the fee imposed on hospitals under this subsection must be based on the assessment by the designated agency of the amount needed to cover the reasonable costs incurred by the designated agency in supervising hospitals under this subchapter and in implementing and administering this chapter.
(b)  Fees collected under this section may be appropriated to the designated agency for purposes of covering costs relating to the implementation and administration of this chapter, including the supervision of hospitals under this chapter.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter D. Enforcement Authority by Designated Agency › Section 314A.151. Investigation; Revocation of Certificate

Sec. 314A.151.  INVESTIGATION; REVOCATION OF CERTIFICATE.  With respect to each hospital resulting from a merger agreement for which the designated agency issued a certificate of public advantage under this chapter, and to ensure that the hospital's activities continue to benefit the public under the standard prescribed by Section 314A.056(a)(1) and the purposes of this chapter, the designated agency may:
(1)  investigate the hospital's activities; and
(2)  require the hospital to perform a certain action or refrain from a certain action or revoke the hospital's certificate of public advantage, if the designated agency determines that:
(A)  the hospital is not complying with this chapter or a term or condition of compliance with the certificate of public advantage governing the hospital's immunized activities;
(B)  the designated agency's approval and issuance of the certificate of public advantage was obtained as a result of material misrepresentation;
(C)  the hospital has failed to pay any fee required under this chapter; or
(D)  the benefits resulting from the approved merger no longer outweigh the disadvantages attributable to the reduction in competition resulting from the approved merger.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter D. Enforcement Authority by Designated Agency › Section 314A.152. Judicial Review of Designated Agency Action

Sec. 314A.152.  JUDICIAL REVIEW OF DESIGNATED AGENCY ACTION.  (a)  A person aggrieved by a decision of the designated agency in granting, denying, or refusing to act on an application for a certificate of public advantage submitted under Subchapter B or revoking a certificate of public advantage issued under this chapter may appeal the final order by filing a petition for judicial review in a district court of Travis County.
(b)  The filing of a petition for judicial review of a decision by the designated agency to revoke a certificate of public advantage stays enforcement of the agency's decision.
(c)  Not later than the 45th day after the date a person files a petition for judicial review under this section, the designated agency shall submit to the district court the original copy or a certified copy of the entirety of the agency's record regarding the decision under review.  By stipulation of all parties, the record may be shortened.  The district court may require or permit later corrections or additions to the record.  The district court may extend the period prescribed by this subsection for submitting the agency's record to the court.
(d)  The district court shall conduct the review sitting without a jury.
(e)  The district court may reverse a decision by the designated agency regarding revocation of a certificate of public advantage if the court finds that the decision is:
(1)  in violation of a constitutional or statutory provision;
(2)  in excess of the agency's statutory authority;
(3)  made through unlawful procedure;
(4)  arbitrary or capricious or characterized by abuse of discretion or clearly unwarranted exercise of discretion; or
(5)  unsupported by substantial and material evidence in light of the record as a whole.
(f)  Under Subsection (e)(5), in determining the substantiality of the evidence, the district court:
(1)  shall consider other evidence that detracts from the substantiality; and
(2)  may not substitute its judgment for the judgment of the designated agency on the weight of the evidence as to a question of fact.
(g)  The district court shall issue a written decision setting forth the court's findings of fact and conclusions of law.  The designated agency shall add the court's decision to the agency's record.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter E. Attorney General Investigation and Enforcement Authority › Section 314A.201. Civil Investigative Demand

Sec. 314A.201.  CIVIL INVESTIGATIVE DEMAND.  (a)  The attorney general, at any time after an application is filed under Section 314A.052 and before the designated agency makes a determination on the application, or in connection with the agency's annual review of a certificate of public advantage under Section 314A.059, may require by civil investigative demand the attendance and testimony of witnesses and the production of documents in Travis County or the county in which the applicants are located for the purpose of investigating whether the merger agreement satisfies or, after issuance of the certificate of public advantage, continues to satisfy the standard prescribed by Section 314A.056(a)(1).
(b)  All nonpublic documents produced for and testimony given to the attorney general under Subsection (a) are subject to the prohibitions on disclosure and use under Section 15.10(i), Business & Commerce Code.
(c)  The attorney general may seek an order from the district court compelling compliance with a civil investigative demand issued under this section.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 314A - Merger Agreements Among Certain Hospitals › Subchapter E. Attorney General Investigation and Enforcement Authority › Section 314A.202. Action to Revoke Certificate of Public Advantage Following Changed Circumstances

Sec. 314A.202.  ACTION TO REVOKE CERTIFICATE OF PUBLIC ADVANTAGE FOLLOWING CHANGED CIRCUMSTANCES.  (a)  If, following an annual review of a certificate of public advantage, the attorney general determines that as a result of changed circumstances the benefits resulting from a certified merger agreement as described by Section 314A.056(a)(1)(A) no longer outweigh any disadvantages attributable to a reduction in competition resulting from the merger agreement, the attorney general may bring an action in a district court in Travis County seeking to revoke the certificate of public advantage in accordance with the procedures prescribed by this section.
(b)  Except as provided by Subsection (c), in an action brought under this section, the attorney general has the burden of establishing by clear and convincing evidence that as a result of changed circumstances the benefits resulting from the certified merger agreement and the unavoidable costs of revoking the certificate of public advantage are outweighed by disadvantages attributable to a reduction in competition resulting from the merger agreement.
(c)  In any action brought under this section, if the attorney general first establishes by clear and convincing evidence that the designated agency's certification was obtained as a result of material misrepresentation to the designated agency or the attorney general or as the result of coercion, threats, or intimidation directed toward any party to the merger agreement, then the parties to the merger agreement bear the burden of establishing by clear and convincing evidence that despite changed circumstances the benefits resulting from the certified merger agreement and the unavoidable costs of revoking the certificate of public advantage are not outweighed by disadvantages attributable to a reduction in competition resulting from the merger agreement.
Added by Acts 2019, 86th Leg., R.S., Ch. 1168 (H.B. 3301), Sec. 1, eff. September 1, 2019.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 315 - Authority to Borrow Money for Public Hospitals › Section 315.001. Definition

Sec. 315.001.  DEFINITION.  In this chapter, "local governmental entity" includes:
(1)  a hospital district created under general or special law;
(2)  a municipal hospital authority;
(3)  a county hospital authority;
(4)  a municipality; or
(5)  a county.
Added by Acts 2011, 82nd Leg., R.S., Ch. 611 (S.B. 494), Sec. 1, eff. September 1, 2011.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 315 - Authority to Borrow Money for Public Hospitals › Section 315.002. Authority to Borrow Money for Public Hospital; Security

Sec. 315.002.  AUTHORITY TO BORROW MONEY FOR PUBLIC HOSPITAL; SECURITY.  (a)  A local governmental entity may borrow money for purposes of a hospital owned or operated by the entity at a rate not to exceed the maximum annual percentage rate allowed by the law at the time the loan is made for similar obligations of the entity.
(b)  To secure a loan under this section, a local governmental entity may pledge:
(1)  revenue from the hospital owned or operated by the entity that is not pledged to pay the entity's bonded indebtedness; or
(2)  tax revenue to be collected by the local governmental entity during the 12-month period following the date of the pledge that is not pledged to pay the principal of or interest on bonds.
(c)  A loan authorized by this section must mature:
(1)  not later than the first anniversary of the date the loan is made, if taxes are pledged to repay the loan; and
(2)  not later than the fifth anniversary of the date the loan is made, if hospital revenue is pledged to repay the loan.
Added by Acts 2011, 82nd Leg., R.S., Ch. 611 (S.B. 494), Sec. 1, eff. September 1, 2011.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 316 - Establishment of Health Care Collaboratives › Section 316.001. Authority to Establish Health Care Collaborative

Sec. 316.001.  AUTHORITY TO ESTABLISH HEALTH CARE COLLABORATIVE.  A public hospital created under Subtitle C or D or a hospital district created under general or special law may form and sponsor a nonprofit health care collaborative that is certified under Chapter 848, Insurance Code.
Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 4.04, eff. September 28, 2011.