reglab/statecodes huggingface dataset:
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle E - Cooperative Associations › Chapter 301 - Cooperative Associations › Subchapter B. Miscellaneous Cooperative Associations › Section 301.044. Surplus Revenue

Sec. 301.044.  SURPLUS REVENUE.  The directors of a cooperative association may, in accordance with the association's bylaws, deposit to the credit of the surplus fund any surplus revenue derived from a system or divide the surplus revenue among the patrons in proportion to the patrons' respective contributions to the working capital of the association and their patronage.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle E - Cooperative Associations › Chapter 301 - Cooperative Associations › Subchapter B. Miscellaneous Cooperative Associations › Section 301.045. Loans to Members Prohibited

Sec. 301.045.  LOANS TO MEMBERS PROHIBITED.  A cooperative association may not loan money to a member.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle E - Cooperative Associations › Chapter 301 - Cooperative Associations › Subchapter B. Miscellaneous Cooperative Associations › Section 301.046. Liberal Construction

Sec. 301.046.  LIBERAL CONSTRUCTION.  This subchapter shall be liberally construed.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle E - Cooperative Associations › Chapter 301 - Cooperative Associations › Subchapter B. Miscellaneous Cooperative Associations › Section 301.047. Construction of Subchapter

Sec. 301.047.  CONSTRUCTION OF SUBCHAPTER.  (a)  This subchapter does not prevent a cooperative association from:
(1)  creating recourse or nonrecourse debt in the form of bonds, debentures, notes, or any other form of obligation;
(2)  encumbering, mortgaging, pledging, or granting a security interest in any property of the cooperative association;
(3)  refunding existing debt or obligations by any means available under this subchapter;  or
(4)  otherwise exercising all express or implied powers granted by Section 301.033(b), 301.037, 301.038, 301.039, or 301.044, or granted by state corporation laws.
(b)  This section only clarifies the powers of cooperative associations and does not expand their powers.
Added by Acts 1993, 73rd Leg., ch. 902, Sec. 1, eff. June 19, 1993.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter A. General Provisions › Section 311.001. Special Hospital Requirements for Graduate of Foreign Medical School Prohibited

Sec. 311.001.  SPECIAL HOSPITAL REQUIREMENTS FOR GRADUATE OF FOREIGN MEDICAL SCHOOL PROHIBITED.  (a)  A hospital may not, as a condition to beginning a hospital internship or residency, require a United States citizen who resides in this state and who holds a diploma from a medical school outside the United States that is listed in the AVICENNA Directory for Medicine published by the University of Copenhagen, in collaboration with the World Health Organization and the World Federation for Medical Education, to:
(1)  take an examination other than an examination required by the Texas Medical Board to be taken by a graduate of a medical school in the United States before allowing that graduate to begin an internship or residency;
(2)  complete a period of internship or graduate clinical training; or
(3)  be certified by the Educational Commission for Foreign Medical Graduates.
(b)  This section applies only to a hospital that:
(1)  is licensed by this state;
(2)  is operated by this state or a political subdivision of this state;  or
(3)  receives direct or indirect state financial assistance.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0835, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter A. General Provisions › Section 311.0025. Audits of Billing

Sec. 311.0025.  AUDITS OF BILLING.  (a)  A hospital, treatment facility, mental health facility, or health care professional may not submit to a patient or a third party payor a bill for a treatment that the hospital, facility, or professional knows was not provided or knows was improper, unreasonable, or medically or clinically unnecessary.
(b)  If the appropriate licensing agency receives a complaint alleging a violation of Subsection (a), the agency may audit the billings and patient records of the hospital, treatment facility, mental health facility, or health care professional.
(c)  A hospital, treatment facility, mental health facility, or health care professional that violates Subsection (a) is subject to disciplinary action, including denial, revocation, suspension, or nonrenewal of the license of the hospital, facility, or professional.  Disciplinary action taken under this section is in addition to any other civil, administrative, or criminal penalty provided by law.
(d)  In this section:
(1)  "Health care professional" means an individual licensed, certified, or regulated by a health care regulatory agency who is eligible for reimbursement for treatment ordered or rendered by that professional.
(2)  "Hospital" means a hospital licensed under Chapter 241.
(3)  "Mental health facility" means a mental health facility licensed under Chapter 577.
(4)  "Treatment facility" means a treatment facility licensed under Chapter 464.
(e)  A licensing agency may not take disciplinary action against a hospital, treatment facility, mental health facility, or health care professional for unknowing and isolated billing errors.
Added by Acts 1993, 73rd Leg., ch. 903, Sec. 2.02, eff. Aug. 30, 1993.  Amended by Acts 1999, 76th Leg., ch. 1271, Sec. 1, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter A. General Provisions › Section 311.003. Reimbursement for Infant Transport to Hospital Neonatal Intensive Care Unit

Sec. 311.003.  REIMBURSEMENT FOR INFANT TRANSPORT TO HOSPITAL NEONATAL INTENSIVE CARE UNIT.  (a)  A hospital that agrees to admit an infant into its level III neonatal intensive care unit shall pay for the part of the cost of transporting the infant to the hospital from any location in this state that the hospital administrator determines cannot be paid:
(1)  by a member of the infant's immediate family or other person legally responsible for the infant's support through personal means;  or
(2)  by insurance or another benefit system that pays for transportation for that purpose.
(b)  A hospital is entitled to receive state reimbursement for funds spent by the hospital under Subsection (a).
(c)  The Department of State Health Services shall administer the state funds for reimbursement under this section, and may spend not more than $100,000 each fiscal year from earned federal funds or private donations to implement this section.
(d)  The executive commissioner of the Health and Human Services Commission shall adopt rules that establish qualifications for reimbursement and provide procedures for applying for reimbursement.
(e)  In this section, "level III neonatal intensive care unit" means a neonatal care unit that complies with standards adopted by the American Academy of Pediatrics.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0837, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter A. General Provisions › Section 311.004. Standardized Patient Risk Identification System

Sec. 311.004.  STANDARDIZED PATIENT RISK IDENTIFICATION SYSTEM.  (a)  In this section:
(1)  "Department" means the Department of State Health Services.
(1-a)  "Executive commissioner" means the executive commissioner of the Health and Human Services Commission.
(2)  "Hospital" means a general or special hospital as defined by Section 241.003.  The term includes a hospital maintained or operated by this state.
(b)  Repealed by Acts 2015, 84th Leg., R.S., Ch. 1, Sec. 3.1639(69), eff. April 2, 2015.
(c)  Unless the department authorizes an exemption for the reason stated in Subsection (d), the department shall require each hospital to implement and enforce the statewide standardized patient risk identification system under which a patient with a specific medical risk may be readily identified through the use of the system to communicate to hospital personnel the existence of that risk.
(d)  The department may exempt from the statewide standardized patient risk identification system a hospital that seeks to adopt another patient risk identification methodology supported by evidence-based protocols for the practice of medicine.
(e)  The department shall modify the statewide standardized patient risk identification system in accordance with evidence-based medicine as necessary.
(f)  The executive commissioner may adopt rules to implement this section.
Added by Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 5.01, eff. September 28, 2011.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0838, eff. April 2, 2015.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0839, eff. April 2, 2015.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1639(69), eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter A. General Provisions › Section 311.005. Water Wells for Use by Hospitals in Certain Counties in Event of Emergency or Natural Disaster

Sec. 311.005.  WATER WELLS FOR USE BY HOSPITALS IN CERTAIN COUNTIES IN EVENT OF EMERGENCY OR NATURAL DISASTER.  (a)  This section applies only to a hospital located in a county that:
(1)  has a population of more than 250,000; and
(2)  borders the Neches River.
(b)  A hospital to which this section applies may drill a water well on property owned by the hospital for the purpose of producing water to supplement the hospital's water supply in the event that an emergency or natural disaster prevents the hospital from receiving water from the hospital's usual source.
(c)  This section does not affect the authority of a groundwater conservation district to regulate groundwater production under Chapter 36, Water Code, or other law governing a groundwater conservation district.
Added by Acts 2023, 88th Leg., R.S., Ch. 978 (S.B. 2406), Sec. 1, eff. September 1, 2023.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter B. Emergency Services › Section 311.021. Definition

Sec. 311.021.  DEFINITION.  In this subchapter, "emergency services" means services that are usually and customarily available at a hospital and that must be provided immediately to:
(1)  sustain a person's life;
(2)  prevent serious permanent disfigurement or loss or impairment of the function of a body part or organ;  or
(3)  provide for the care of a woman in active labor or, if the hospital is not equipped for that service, to provide necessary treatment to allow the woman to travel to a more appropriate facility without undue risk of serious harm.
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 311 - Powers and Duties of Hospitals › Subchapter B. Emergency Services › Section 311.022. Discrimination Prohibited in Denial of Services; Criminal Penalties

Sec. 311.022.  DISCRIMINATION PROHIBITED IN DENIAL OF SERVICES;  CRIMINAL PENALTIES.  (a)  An officer, employee, or medical staff member of a general hospital may not deny emergency services because a person cannot establish the person's ability to pay for the services or because of the person's race, religion, or national ancestry if:
(1)  the services are available at the hospital;  and
(2)  the person is diagnosed by a licensed physician as requiring those services.
(b)  An officer or employee of a general hospital may not deny a person in need of emergency services access to diagnosis by a licensed physician on the hospital staff because the person cannot establish the person's ability to pay for the services or because of the person's race, religion, or national ancestry.
(c)  In addition, the person needing emergency services may not be subjected to arbitrary, capricious, or unreasonable discrimination based on age, sex, physical condition, or economic status.
(d)  An officer, employee, or medical staff member of a general hospital commits an offense if that person recklessly violates this section.  An offense under this subsection is a Class B misdemeanor, except that if the offense results in permanent injury, permanent disability, or death, the offense is a Class A misdemeanor.
(e)  An officer, employee, or medical staff member of a general hospital commits an offense if that person intentionally or knowingly violates this section.  An offense under this subsection is a Class A misdemeanor, except that if, as a direct result of the offense, a person denied emergency services dies, the offense is a felony of the third degree.
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 311 - Powers and Duties of Hospitals › Subchapter B. Emergency Services › Section 311.023. No Liability for Failure to Provide Emergency Services After Good Faith Effort

Sec. 311.023.  NO LIABILITY FOR FAILURE TO PROVIDE EMERGENCY SERVICES AFTER GOOD FAITH EFFORT.  An employee of a general hospital that does not have physician services available at the time of an emergency is not in violation of Section 311.022 if, after a reasonable good faith effort, a physician fails to provide or delegate the provision of medical services as required by state statutes.
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 311 - Powers and Duties of Hospitals › Subchapter B. Emergency Services › Section 311.024. Payment for Services Required

Sec. 311.024.  PAYMENT FOR SERVICES REQUIRED.  This subchapter does not relieve a person of that person's obligation to pay for services provided by a hospital if the person can pay for those services.
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 311 - Powers and Duties of Hospitals › Subchapter C. Hospital Data Reporting and Collection System › Section 311.032. Department Administration of Hospital Reporting and Collection System

Sec. 311.032.  DEPARTMENT ADMINISTRATION OF HOSPITAL REPORTING AND COLLECTION SYSTEM.  (a)  The department shall establish a uniform reporting and collection system for hospital financial and utilization data.
(b)  The executive commissioner shall adopt necessary rules consistent with this subchapter to govern the reporting and collection of data.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1995, 74th Leg., ch. 726, Sec. 2, eff. Sept. 1, 1995.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0841, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter C. Hospital Data Reporting and Collection System › Section 311.033. Financial and Utilization Data Required

Sec. 311.033.  FINANCIAL AND UTILIZATION DATA REQUIRED.  (a)  A hospital shall submit to the department financial and utilization data for that hospital, including data relating to the hospital's:
(1)  total gross revenue, including:
(A)  Medicare gross revenue;
(B)  Medicaid gross revenue;
(C)  other revenue from state programs;
(D)  revenue from local government programs;
(E)  local tax support;
(F)  charitable contributions;
(G)  other third party payments;
(H)  gross inpatient revenue; and
(I)  gross outpatient revenue;
(2)  total deductions from gross revenue, including:
(A)  contractual allowance; and
(B)  any other deductions;
(3)  charity care;
(4)  bad debt expense;
(5)  total admissions, including:
(A)  Medicare admissions;
(B)  Medicaid admissions;
(C)  admissions under a local government program;
(D)  charity care admissions; and
(E)  any other type of admission;
(6)  total discharges;
(7)  total patient days;
(8)  average length of stay;
(9)  total outpatient visits;
(10)  total assets;
(11)  total liabilities;
(12)  estimates of unreimbursed costs of subsidized health services reported separately in the following categories:
(A)  emergency care and trauma care;
(B)  neonatal intensive care;
(C)  free-standing community clinics;
(D)  collaborative efforts with local government or private agencies in preventive medicine, such as immunization programs; and
(E)  other services that satisfy the definition of "subsidized health services" contained in Section 311.031(15);
(13)  donations;
(14)  total cost of reimbursed and unreimbursed research;
(15)  total cost of reimbursed and unreimbursed education separated into the following categories:
(A)  education of physicians, nurses, technicians, and other medical professionals and health care providers;
(B)  scholarships and funding to medical schools, colleges, and universities for health professions education;
(C)  education of patients concerning diseases and home care in response to community needs;
(D)  community health education through informational programs, publications, and outreach activities in response to community needs; and
(E)  other educational services that satisfy the definition of "education-related costs" under Section 311.031(6).
(b)  The data must be based on the hospital's most recent audited financial records.
(c)  The data must be submitted in the form prescribed by the department and at the time established by department rule.
(d)  A hospital that does not submit to the department the data required under this section is subject to civil penalties under Section 104.043.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1993, 73rd Leg., ch. 360, Sec. 2, eff. Sept. 1, 1993.
Amended by:
Acts 2009, 81st Leg., R.S., Ch. 797 (S.B. 1326), Sec. 11, eff. June 19, 2009.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0842, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter C. Hospital Data Reporting and Collection System › Section 311.0335. Mental Health and Chemical Dependency Data

Sec. 311.0335.  MENTAL HEALTH AND CHEMICAL DEPENDENCY DATA.  (a)  A hospital that provides mental health or chemical dependency services shall submit to the department financial and utilization data relating to the mental health and chemical dependency services provided by the hospital, including data for inpatient and outpatient services relating to:
(1)  patient demographics, including race, ethnicity, age, gender, and county of residence;
(2)  admissions;
(3)  discharges, including length of inpatient treatment;
(4)  specific diagnoses and procedures according to criteria prescribed by the Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, Revised, or a later version prescribed by department rule;
(5)  total charges and the components of the charges;
(6)  payor sources; and
(7)  use of mechanical restraints.
(b)  The data must be submitted in the form prescribed by the department and at the time established by department rule.
Added by Acts 1993, 73rd Leg., ch. 705, Sec. 6.02, eff. Sept. 1, 1993.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0843, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter C. Hospital Data Reporting and Collection System › Section 311.035. Use of Data

Sec. 311.035.  USE OF DATA.  (a)  The department shall use the data collected under this subchapter to publish an annual report regarding:
(1)  the amount of charity care, bad debt, and other uncompensated care hospitals provide;
(2)  the use of hospital services by indigent patients;  and
(3)  the effect of indigent care services on hospitals.
(b)  Repealed by Acts 1995, 74th Leg., ch. 726, Sec. 5(1), eff. Sept. 1, 1995.
(c)  The department shall enter into an interagency agreement with the Texas Department of Insurance relating to the mental health and chemical dependency data collected under Section 311.0335.  The agreement shall address the collection, analysis, and sharing of the data by the agencies.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1993, 73rd Leg., ch. 705, Sec. 6.03, eff. Sept. 1, 1993;  Acts 1995, 74th Leg., ch. 726, Sec. 3, 5(1), eff. Sept. 1, 1995.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0844, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter C. Hospital Data Reporting and Collection System › Section 311.036. Data Verification

Sec. 311.036.  DATA VERIFICATION.  (a)  Before the department may publish the report required by Section 311.035 or provide data to the public in any other manner, the department shall give each hospital a copy of the preliminary report or provide the hospital an opportunity in some other manner to verify the data relating to that hospital.
(b)  If a hospital does not submit corrected data before the 31st day after the date on which the hospital receives the preliminary report or other data, the department shall presume that the data is correct.
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 311 - Powers and Duties of Hospitals › Subchapter C. Hospital Data Reporting and Collection System › Section 311.037. Confidential Data; Criminal Penalty

Sec. 311.037.  CONFIDENTIAL DATA;  CRIMINAL PENALTY.  (a)  The following data reported or submitted to the department under this subchapter is confidential:
(1)  data regarding a specific patient;  or
(2)  financial data regarding a provider or facility submitted to the department before September 1, 1987.  All financial data regarding a provider or facility submitted after September 1, 1987, are no longer confidential.
(b)  Before the department may disclose confidential data under this subchapter, the department must remove any information that identifies a specific patient.
(c)  A person commits an offense if the person:
(1)  discloses, distributes, or sells confidential data obtained under this subchapter;  or
(2)  violates Subsection (b).
(d)  An offense under Subsection (c) is a Class B misdemeanor.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1993, 73rd Leg., ch. 360, Sec. 3, eff. Sept. 1, 1993.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter C. Hospital Data Reporting and Collection System › Section 311.039. Exemption

Sec. 311.039.  EXEMPTION.  A hospital may, but is not required to, provide the data required by Section 311.033 if the hospital:
(1)  is exempt from state franchise, sales, ad valorem, or other state or local taxes;  and
(2)  does not seek or receive reimbursement for providing health care services to patients from any source, including:
(A)  the patient or any person legally obligated to support the patient;
(B)  a third party payor;  or
(C)  Medicaid, Medicare, or any other federal, state, or local program for indigent health care.
Added by Acts 1997, 75th Leg., ch. 261, Sec. 15, eff. Sept. 1, 1997.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter D. Community Benefits and Charity Care › Section 311.041. Policy Statement

Sec. 311.041.  POLICY STATEMENT.  It is the purpose of this subchapter to clarify and set forth the duties, responsibilities, and benefits that apply to hospitals for providing community benefits that include charity care.
Added by Acts 1993, 73rd Leg., ch. 360, Sec. 4, eff. Sept. 1, 1993.  Amended by Acts 2003, 78th Leg., ch. 204, Sec. 22.01, eff. Sept. 1, 2003.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter D. Community Benefits and Charity Care › Section 311.043. Duty of Nonprofit Hospitals to Provide Community Benefits

Sec. 311.043.  DUTY OF NONPROFIT HOSPITALS TO PROVIDE COMMUNITY BENEFITS.  (a)  A nonprofit hospital shall provide health care services to the community and shall comply with all federal, state, and local government requirements for tax exemption in order to maintain such exemption.  These health care services to the community shall include charity care and government-sponsored indigent health care and may include other components of community benefits as both terms are defined in Sections 311.031 and 311.042.
(b)  In order to qualify as a charitable organization under Sections 11.18(d)(1), 151.310(a)(2) and (e), and 171.063(a)(1), Tax Code, and to satisfy the requirements of this subchapter, a nonprofit hospital shall provide community benefits, which include charity care and government-sponsored indigent health care, in an amount that satisfies the requirements of Section 311.045.  A determination of the amount of charity care and government-sponsored indigent health care provided by a hospital shall be based on the most recently completed and audited prior fiscal year of the hospital.
(c)  Reductions in the amount of community benefits, which includes charity care and government-sponsored indigent health care, provided by a nonprofit hospital shall be considered reasonable when the financial reserves of the hospital are reduced to such a level that the hospital would be in violation of any applicable bond covenants, when necessary to prevent the hospital from endangering its ability to continue operations, or if the hospital, as a result of a natural or other disaster, is required substantially to curtail its operations.
(d)  A hospital's admissions policy must provide for the admission of financially indigent and medically indigent persons pursuant to its charity care requirements as set forth in this subchapter.
Added by Acts 1993, 73rd Leg., ch. 360, Sec. 4, eff. Sept. 1, 1993.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter D. Community Benefits and Charity Care › Section 311.044. Community Benefits Planning by Nonprofit Hospitals

Sec. 311.044.  COMMUNITY BENEFITS PLANNING BY NONPROFIT HOSPITALS.  (a)  A nonprofit hospital shall develop:
(1)  an organizational mission statement that identifies the hospital's commitment to serving the health care needs of the community;  and
(2)  a community benefits plan defined as an operational plan for serving the community's health care needs that sets out goals and objectives for providing community benefits that include charity care and government-sponsored indigent health care, as the terms community benefits, charity care, and government-sponsored indigent health care are defined by Sections 311.031 and 311.042, and that identifies the populations and communities served by the hospital.
(b)  When developing the community benefits plan, the hospital shall consider the health care needs of the community as determined by community-wide needs assessments.  For purposes of this subsection, "community" means the primary geographic area and patient categories for which the hospital provides health care services;  provided, however, that the primary geographic area shall at least encompass the entire county in which the hospital is located.
(c)  The hospital shall include at least the following elements in the community benefits plan:
(1)  mechanisms to evaluate the plan's effectiveness, including but not limited to a method for soliciting the views of the communities served by the hospital;
(2)  measurable objectives to be achieved within a specified time frame;  and
(3)  a budget for the plan.
(d)  In determining the community-wide needs assessment required by Subsection (b), a nonprofit hospital shall consider consulting with and seeking input from representatives of the following entities or organizations located in the community as defined by Subsection (b):
(1)  the local health department;
(2)  the public health region under Chapter 121;
(3)  the public health district;
(4)  health-related organizations, including a health professional association or hospital association;
(5)  health science centers;
(6)  private business;
(7)  consumers;
(8)  local governments;  and
(9)  insurance companies and managed care organizations with an active market presence in the community.
(e)  Representatives of a nonprofit hospital shall consider meeting with representatives of the entities and organizations listed in Subsection (d) to assess the health care needs of the community and population served by the nonprofit hospital.
Added by Acts 1993, 73rd Leg., ch. 360, Sec. 4, eff. Sept. 1, 1993.  Amended by Acts 1997, 75th Leg., ch. 1101, Sec. 1, eff. Sept. 1, 1997.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter D. Community Benefits and Charity Care › Section 311.0455. Annual Report by the Department

Sec. 311.0455.  ANNUAL REPORT BY THE DEPARTMENT.  (a)  The department shall submit to the attorney general and comptroller not later than July 1 of each year a report listing each nonprofit hospital or hospital system that did not meet the requirements of Section 311.045 during the preceding fiscal year.
(b)  The department shall submit to the attorney general and the comptroller not later than November 1 of each year a report containing the following information for each nonprofit hospital or hospital system during the preceding fiscal year:
(1)  the amount of charity care, as defined by Section 311.031, provided;
(2)  the amount of government-sponsored indigent health care, as defined by Section 311.031, provided;
(3)  the amount of community benefits, as defined by Section 311.042, provided;
(4)  the amount of net patient revenue, as defined by Section 311.042, and the amount constituting four percent of net patient revenue;
(5)  the dollar amount of the hospital's or hospital system's charity care and community benefits requirements met;
(6)  a computation of the percentage by which the amount described by Subdivision (5) is above or below the dollar amount of the hospital's or hospital system's charity care and community benefits requirements;
(7)  the amount of tax-exempt benefits, as defined by Section 311.042, provided, if the hospital is required to report tax-exempt benefits under Section 311.045(b)(1)(A) or (b)(1)(B);  and
(8)  the amount of charity care expenses reported in the hospital's or hospital system's audited financial statement.
(c)  The department shall make the report required by Subsection (b) available to the public and shall issue a press release concerning the availability of the report.
(d)  For purposes of Subsection (b), "nonprofit hospital" includes the following if the hospital is not located in a county with a population under 50,000 where the entire county or the population of the entire county has been designated as a Health Professionals Shortage Area:
(1)  a Medicaid disproportionate share hospital;  or
(2)  a public hospital that is owned or operated by a political subdivision or municipal corporation of the state, including a hospital district or authority.
Added by Acts 1997, 75th Leg., ch. 260, Sec. 2, eff. Jan. 1, 1998.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter D. Community Benefits and Charity Care › Section 311.0461. Informational Manual

Sec. 311.0461.  INFORMATIONAL MANUAL.  The department shall annually publish a manual that lists each nonprofit hospital in this state with a brief summary of the charity care policies and community benefits that the nonprofit hospital provides.
Added by Acts 2001, 77th Leg., ch. 654, Sec. 3, eff. Sept. 1, 2001.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter D. Community Benefits and Charity Care › Section 311.047. Penalties

Sec. 311.047.  PENALTIES.  The department may assess a civil penalty against a nonprofit hospital that fails to make a report of the community benefits plan as required under this subchapter.  The penalty may not exceed $1,000 for each day a report is delinquent after the date on which the report is due.  No penalty may be assessed against a hospital under this subsection until 10 business days have elapsed after written notification to the hospital of its failure to file a report.
Added by Acts 1993, 73rd Leg., ch. 360, Sec. 4, eff. Sept. 1, 1993.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter D. Community Benefits and Charity Care › Section 311.048. Rights and Remedies

Sec. 311.048.  RIGHTS AND REMEDIES.  The rights and remedies provided for in this subchapter shall not limit, affect, change, or repeal any other statutory or common-law rights or remedies available to the state or a nonprofit hospital.
Added by Acts 1993, 73rd Leg., ch. 360, Sec. 4, eff. Sept. 1, 1993.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter E. Employment of Physicians by Certain Hospitals Associated With Nonprofit Fraternal Organizations › Section 311.061. Applicability of Subchapter

Sec. 311.061.  APPLICABILITY OF SUBCHAPTER.  This subchapter applies only to a hospital that employs or seeks to employ a physician, that primarily provides medical care to children younger than 18 years of age, and that:
(1)  is owned or operated by a nonprofit fraternal organization; or
(2)  has a governing body the majority of members of which belong to a nonprofit fraternal organization.
Added by Acts 2011, 82nd Leg., R.S., Ch. 901 (S.B. 761), Sec. 1, eff. June 17, 2011.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter E. Employment of Physicians by Certain Hospitals Associated With Nonprofit Fraternal Organizations › Section 311.062. Employment of Physicians Permitted

Sec. 311.062.  EMPLOYMENT OF PHYSICIANS PERMITTED.  (a)  A hospital may employ a physician and retain all or part of the professional income generated by the physician for medical services provided at the hospital if the hospital satisfies the requirements of this subchapter.
(b)  The billing and receipt of third-party reimbursement for medical care at a hospital does not affect the authority granted to the hospital under this section.
Added by Acts 2011, 82nd Leg., R.S., Ch. 901 (S.B. 761), Sec. 1, eff. June 17, 2011.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter E. Employment of Physicians by Certain Hospitals Associated With Nonprofit Fraternal Organizations › Section 311.063. Duties and Hospital Policies

Sec. 311.063.  DUTIES AND HOSPITAL POLICIES.  (a)  A hospital that employs physicians under this subchapter shall:
(1)  appoint a chief medical officer, who may be a member of the hospital's medical staff;
(2)  adopt, maintain, and enforce policies to ensure that a physician employed by the hospital exercises the physician's independent medical judgment in providing care to patients at the hospital; and
(3)  designate the chief medical officer as the contact for the Texas Medical Board for all matters relating to complaints regarding interference or attempted interference with a physician's independent medical judgment or any other matter under this section.
(b)  The person appointed as chief medical officer shall report the person's appointment to the Texas Medical Board.
(c)  The policies adopted under this section must include:
(1)  policies relating to:
(A)  credentialing;
(B)  quality assurance;
(C)  utilization review;
(D)  peer review; and
(E)  medical decision-making; and
(2)  the implementation of a complaint mechanism to process and resolve complaints regarding interference or attempted interference with a physician's independent medical judgment.
(d)  The policies adopted under this section must be approved by the chief medical officer.
(e)  In the event of a conflict between a policy approved by the chief medical officer and any other policy of the hospital, a conflict management process shall be jointly developed and implemented to resolve the conflict.
(f)  For all matters relating to the practice of medicine, each physician employed by a hospital under this subchapter shall ultimately report to the chief medical officer.
(g)  The chief medical officer shall immediately report to the Texas Medical Board any action or event that the chief medical officer reasonably and in good faith believes constitutes a compromise of the independent medical judgment of a physician in caring for a patient.
Added by Acts 2011, 82nd Leg., R.S., Ch. 901 (S.B. 761), Sec. 1, eff. June 17, 2011.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter E. Employment of Physicians by Certain Hospitals Associated With Nonprofit Fraternal Organizations › Section 311.064. Construction of Subchapter

Sec. 311.064.  CONSTRUCTION OF SUBCHAPTER.  This subchapter may not be construed as authorizing the governing body of a hospital to supervise or control the practice of medicine as prohibited under Subtitle B, Title 3, Occupations Code.
Added by Acts 2011, 82nd Leg., R.S., Ch. 901 (S.B. 761), Sec. 1, eff. June 17, 2011.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter F. Employment of Physicians by Certain Hospitals › Section 311.081. Applicability and Construction of Subchapter

Sec. 311.081.  APPLICABILITY AND CONSTRUCTION OF SUBCHAPTER.  (a)  This subchapter applies only to a hospital that employs or seeks to employ a physician and that:
(1)  is designated as a critical access hospital under the authority of and in compliance with 42 U.S.C. Section 1395i-4;
(2)  is a sole community hospital, as that term is defined by 42 U.S.C. Section 1395ww(d)(5)(D)(iii); or
(3)  is located in a county with a population of 50,000 or less.
(b)  This subchapter may not be construed as authorizing the governing body of a hospital to supervise or control the practice of medicine, as prohibited under Subtitle B, Title 3, Occupations Code.
(c)  This subchapter applies to medical services provided by a physician at the hospital and other health care facilities owned or operated by the hospital.
Added by Acts 2011, 82nd Leg., R.S., Ch. 55 (S.B. 894), Sec. 1, eff. May 12, 2011.
Redesignated from Health and Safety Code, Section 311.061 by Acts 2013, 83rd Leg., R.S., Ch. 161 (S.B. 1093), Sec. 22.001(27), eff. September 1, 2013.
2023 Texas Statutes › Health and Safety Code › Title 4 - Health Facilities › Subtitle F - Powers and Duties of Hospitals › Chapter 311 - Powers and Duties of Hospitals › Subchapter F. Employment of Physicians by Certain Hospitals › Section 311.082. Employment of Physicians Permitted

Sec. 311.082.  EMPLOYMENT OF PHYSICIANS PERMITTED.  A hospital may employ a physician and retain all or part of the professional income generated by the physician for medical services provided at the hospital and other health care facilities owned or operated by the hospital if the hospital satisfies the requirements of this subchapter.
Added by Acts 2011, 82nd Leg., R.S., Ch. 55 (S.B. 894), Sec. 1, eff. May 12, 2011.
Redesignated from Health and Safety Code, Section 311.062 by Acts 2013, 83rd Leg., R.S., Ch. 161 (S.B. 1093), Sec. 22.001(27), eff. September 1, 2013.
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 312.001. Finding; Purpose

Sec. 312.001.  FINDING;  PURPOSE.  (a)  The legislature finds that the clinical education of medical and dental students, interns, residents, and fellows attending a medical and dental unit or a supported medical or dental school and the provision of patient care to public hospitals can be more effectively and economically undertaken if those institutions and hospitals coordinate and cooperate, rather than compete, in their common endeavors.
(b)  The purpose of this chapter is to authorize coordination and cooperation between medical and dental units, supported medical or dental schools, and public hospitals and to remove impediments to that coordination and cooperation in order to:
(1)  enhance the education of students, interns, residents, and fellows attending a medical and dental unit or a supported medical or dental school;
(2)  enhance patient care;  and
(3)  avoid any waste of public money.
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 312.002. Definitions

Sec. 312.002.  DEFINITIONS.  In this chapter:
(1)  Repealed by Acts 2015, 84th Leg., R.S., Ch. 1, Sec. 3.1639(70), eff. April 2, 2015.
(2)  Repealed by Acts 2015, 84th Leg., R.S., Ch. 1, Sec. 3.1639(70), eff. April 2, 2015.
(3)  "Coordinating entity" means a nonprofit corporation under the Texas Nonprofit Corporation Law as described by Section 1.008(d), Business Organizations Code, that is a health organization approved and certified by the Texas Medical Board under Chapter 162, Occupations Code.
(3-a)  "Department" means the Department of State Health Services.
(4)  "Medical and dental unit" has the meaning assigned by Section 61.003, Education Code.
(5)  "Public hospital" means a hospital, clinic, or other facility for the provision of health care or dental care that is owned or operated by the federal government, the state, or a political subdivision or municipal corporation of the state, including a hospital district or authority.
(6)  "Supported medical or dental school" means a medical school or dental school organized as a nonprofit corporation that is under contract with the Texas Higher Education Coordinating Board to provide educational services under Subchapter D, Chapter 61, Education Code.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.791, eff. Sept. 1, 2001.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0849, eff. April 2, 2015.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1639(70), eff. April 2, 2015.
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 312.003. Agreement Required

Sec. 312.003.  AGREEMENT REQUIRED.  This chapter applies only if the medical and dental unit or supported medical or dental school agrees, either directly or through a coordinating entity, to provide or cause to be provided medical, dental, or other patient care or services or to perform or cause to be performed medical, dental, or clinical education, training, or research activities in a coordinated or cooperative manner in a public or nonprofit hospital.
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. 2, eff. June 12, 2017.
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 312.004. Contracts for Coordination or Cooperation

Sec. 312.004.  CONTRACTS FOR COORDINATION OR COOPERATION.  (a)  Medical and dental units, supported medical or dental schools, coordinating entities, and public hospitals may make and perform contracts among each other for the coordinated or cooperative clinical education of the students, interns, residents, and fellows enrolled at the units or schools.
(b)  Medical and dental units and supported medical or dental schools may undertake coordination or cooperation of clinical education directly or through a coordinating entity.
(c)  A medical and dental unit, a supported medical or dental school, and a coordinating entity may contract with the owner or operator of a public hospital for the clinical education of students, interns, residents, and fellows enrolled at the unit or school.
(d)  The contracting parties may determine the terms of and the consideration for a contract authorized under this section.
(e)  The contract may provide for the coordinated, cooperative, or exclusive assignment of the interns, residents, fellows, faculty, and associated health care professionals of the participating medical and dental units and supported medical or dental schools to provide or perform health or dental services or research at a public hospital.
(f)  Coordinated or cooperative activities authorized under this section may be performed by or on behalf of one or more of the units, schools, or entities involved.
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 312.005. Approval of Contracts

Sec. 312.005.  APPROVAL OF CONTRACTS.  (a)  To be effective, a contract under Section 312.004 must be submitted to the department.
(b)   The department shall approve the contract if the contract furthers the purposes of this chapter.
(c)  The department may disapprove a contract only after notice to all parties and a hearing.
(d)  The department may not modify a contract.
(e)  The contract takes effect:
(1)  when it is approved by the department; or
(2)  on the 31st day after the date on which the contract is filed with the department by a medical and dental unit, supported medical or dental school, or coordinating entity that is a party to the contract, if the department does not approve or disapprove the contract within 30 days after the date on which the contract is filed.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0850, eff. April 2, 2015.