2005 Texas Health & Safety Code CHAPTER 42. KIDNEY HEALTH CARE

HEALTH & SAFETY CODE

CHAPTER 42. KIDNEY HEALTH CARE


	§ 42.001. SHORT TITLE;  PURPOSE.  (a) This chapter may be 
cited as the Texas Kidney Health Care Act.
	(b)  The state finds that one of the most serious and tragic 
problems facing the public health and welfare is the death each year 
from chronic kidney disease of hundreds of persons in this state, 
when the present state of medical art and technology could return 
many of those individuals to a socially productive life.  Patients 
may die for lack of personal financial resources to pay for the 
expensive equipment and care necessary for survival.  The state 
therefore recognizes a responsibility to allow its citizens to 
remain healthy without being pauperized and a responsibility to use 
the resources and organization of the state to gather and 
disseminate information on the prevention and treatment of chronic 
kidney disease.
	(c)  A comprehensive program to combat kidney disease must be 
implemented through the combined and correlated efforts of 
individuals, state and local governments, persons in the field of 
medicine, universities, and nonprofit organizations.  The program 
provided by this chapter is designed to direct the use of resources 
and to coordinate the efforts of the state in this vital matter of 
public health.

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989.                    


	§ 42.002. DEFINITIONS.  In this chapter:                                    
		(1)  "Division" means the kidney health care division.                        
		(2)  "Other benefit" means a benefit, other than one 
provided under this chapter, to which a person is entitled for 
payment of the costs of medical care and treatment, services, 
pharmaceuticals, transportation, and supplies, including benefits 
available from:
			(A)  an insurance policy, group health plan, or 
prepaid medical care plan; 
			(B)  Title XVIII or Title XIX of the Social 
Security Act (42 U.S.C. § 1395 et seq. and 42 U.S.C. § 1396 et 
seq.); 
			(C)  the Veterans Administration;                                            
			(D)  the Civilian Health and Medical Program of 
the Uniformed Services;    
			(E)  workers' compensation or other compulsory 
employers' insurance program; 
			(F)  a public program created by federal law, 
state law, or the ordinances or rules of a municipality or other 
political subdivision of the state, excluding benefits created by 
the establishment of a municipal or county hospital, a joint 
municipal-county hospital, a county hospital authority, or a 
hospital district;  or
			(G)  a cause of action for medical expenses 
brought by an applicant for or recipient of services from the 
department, or a settlement or judgment based on the cause of 
action, if the expenses are related to the need for services 
provided under this chapter.

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989.                    


	§ 42.003. KIDNEY HEALTH CARE DIVISION.  (a) The kidney 
health care division is in the department to carry out this chapter.  
The board shall administer the division.
	(b)  The division may assist in the development and expansion 
of programs for the care and treatment of persons with chronic 
kidney disease, including dialysis and other lifesaving medical 
procedures and techniques.
	(c)  The board may adopt rules necessary to carry out this 
chapter and to provide adequate kidney care and treatment for 
citizens of this state.

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989.                    


	§ 42.004. SERVICES.  (a) The division shall provide 
kidney care services directly or through public or private 
resources to persons determined by the board to be eligible for 
services authorized under this chapter.
	(b)  The division may cooperate with other departments, 
agencies, political subdivisions, and public and private 
institutions to provide the services authorized by this chapter to 
eligible persons, to study the public health and welfare needs 
involved, and to plan, establish, develop, and provide programs or 
facilities and services that are necessary or desirable, including 
any that are jointly administered with state agencies.
	(c)  The division may conduct research and compile 
statistics relating to the provision of kidney care services and 
the need for the services by disabled or handicapped persons.
	(d)  The division may contract with schools, hospitals, 
corporations, agencies, and individuals, including doctors, 
nurses, and technicians, for training, physical restoration, 
transportation, and other services necessary to treat and care for 
persons with kidney disease.

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989.                    


	§ 42.0045. DISTRIBUTION OF DRUGS AND DEVICES.  (a) 
Sections 483.041(a) and 483.042, Subtitle J, Title 3, Occupations 
Code, and other applicable laws establishing prohibitions do not 
apply to a dialysate, device, or drug exclusively used or necessary 
to perform dialysis that a physician prescribes or orders for 
administration or delivery to a person with chronic kidney failure 
if:
		(1)  the dialysate, device, or drug is lawfully held by 
a manufacturer or wholesaler registered with the board;
		(2)  the manufacturer or wholesaler delivers the 
dialysate, device, or drug to:
			(A)  a person with chronic kidney failure for 
self-administration at the person's home or a specified address, as 
ordered by a physician;  or
			(B)  a physician for administration or delivery to 
a person with chronic kidney failure;  and
		(3)  the manufacturer or wholesaler has sufficient and 
qualified supervision to adequately protect the public health.
	(b)  The board shall adopt rules necessary to ensure the safe 
distribution, without the interruption of supply, of a dialysate, 
device, or drug covered by Subsection (a). The rules must include 
provisions regarding manufacturer and wholesaler licensing, record 
keeping, evidence of a delivery to a patient or a patient's 
designee, patient training, specific product and quantity 
limitation, physician prescriptions or order forms, adequate 
facilities, and appropriate labeling to ensure that necessary 
information is affixed to or accompanies the dialysate, device, or 
drug.
	(c)  If the board determines that a dialysate, device, or 
drug distributed under this chapter is ineffective or unsafe for 
its intended use, the board may immediately recall the dialysate, 
device, or drug distributed to an individual patient.
	(d)  A dialysate, device, or drug covered by Subsection (a) 
may be delivered only by:
		(1)  the manufacturer or wholesaler to which the 
physician has issued an order;  or
		(2)  a carrier authorized to possess the dialysate, 
device, or drug under Section 483.041(c).

Added by Acts 1991, 72nd Leg., ch. 14, § 12, eff. Sept. 1, 1991.  
Amended by Acts 2001, 77th Leg., ch. 1420, § 14.769, eff. Sept. 
1, 2001.


	§ 42.005. FACILITIES.  (a) The board may establish and 
maintain standards for the accreditation of all facilities designed 
or intended to deliver care or treatment for persons with chronic 
kidney disease.
	(b)  The division may conduct surveys of existing facilities 
in this state that diagnose, evaluate, and treat patients with 
kidney disease and may prepare and submit its findings and a 
specific program of action.
	(c)  The division may evaluate the need to create local or 
regional facilities and to establish a major kidney research 
center.
	(d)  The division may:                                                         
		(1)  establish or construct rehabilitation facilities 
and workshops;        
		(2)  make grants to public agencies and make contracts 
or other arrangements with public and other nonprofit agencies, 
organizations, or institutions for the establishment of workshops 
and rehabilitation facilities;  and
		(3)  operate facilities to carry out this chapter.                            
	(e)  The board may provide for the establishment, 
supervision, management, and control of kidney care facilities.

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989.                    


	§ 42.006. SELECTION OF SERVICE PROVIDERS.  (a) The 
department shall select providers to furnish kidney health care 
services under the program according to the criteria and procedures 
adopted by the board.
	(b)  The board shall provide a hearing procedure for the 
resolution of conflicts between the department and a provider.  
Chapter 2001, Government Code, do  not apply to conflict resolution 
procedures adopted under this section.
	(c)  The department may not terminate a contract while a 
hearing is pending under this section.  The department may withhold 
payments while the hearing is pending, but shall pay the withheld 
payments and resume contract payments if the final determination is 
in favor of the provider.
	(d)  Subsections (b) and (c) do not apply if a contract:                       
		(1)  is canceled because program services are 
restricted to conform to budgetary limitations that require the 
board to adopt service priorities regarding types of services to be 
furnished or classes of eligible individuals;  or
		(2)  expires according to its terms.                                          

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989.  Amended 
by Acts 1995, 74th Leg., ch. 76, § 5.95(66), eff. Sept. 1, 1995.


	§ 42.007. ELIGIBILITY FOR SERVICES.  The board may 
determine the terms, conditions, and standards, including medical 
and financial standards, for the eligibility of persons with 
chronic kidney disease to receive the aid, care, or treatment 
provided under this chapter.

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989.                    


	§ 42.008. DENIAL, MODIFICATION, SUSPENSION, OR 
TERMINATION OF SERVICES.  (a) After notice and an opportunity for a 
hearing, the department for cause may deny the application of or 
modify, suspend, or terminate services to an applicant for or 
recipient of services.
	(b)  The program rules adopted by the board must contain the 
criteria for the department's action under this section.
	(c)  Chapter 2001, Government Code, do  not apply to the 
granting, denial, modification, suspension, or termination of 
services provided under this chapter.  Hearings under this section 
must be conducted in accordance with the board's hearing rules.
	(d)  This section does not apply if program services are 
restricted to conform to budgetary limitations that require the 
board to adopt service priorities regarding types of services to be 
furnished or classes of eligible persons.

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989.  Amended 
by Acts 1995, 74th Leg., ch. 76, § 5.95(66), eff. Sept. 1, 1995.


	§ 42.009. REIMBURSEMENT.  (a) An applicant or recipient 
is not eligible to receive services provided by this chapter to the 
extent that the applicant or recipient, or another person with a 
legal obligation to support the applicant or recipient, is eligible 
for some other benefit that would pay for all or part of the 
services provided by this chapter.
	(b)  When an application is made under this chapter or at any 
time while a person is eligible and receiving services under this 
chapter, the applicant or recipient, or the person with a legal 
obligation to support the applicant or recipient, shall inform the 
department of any other benefit to which the applicant or 
recipient, or the person with a legal obligation to support the 
applicant or recipient, may be entitled.
	(c)  A recipient who has received services that are covered 
by some other benefit, or the person with a legal obligation to 
support that recipient, shall reimburse the department to the 
extent of the cost of services provided when the other benefit is 
received.
	(d)  The board may waive the provisions of Subsection (a) in 
certain individually considered cases when the enforcement of that 
provision will deny services to a class of end stage renal disease 
patients because of conflicting state or federal laws or rules.

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989.                    


	§ 42.010. RECOVERY OF COSTS.  (a) The department may 
recover the costs of services provided under this chapter from a 
person who does not reimburse the department as required by Section 
42.009(c), or from any third party who has a legal obligation to pay 
other benefits and to whom notice of the department's interest has 
been given.
	(b)  At the request of the commissioner, the attorney general 
may bring suit in the appropriate court of Travis County on behalf 
of the department.
	(c)  In a judgment in favor of the department, the court may 
award attorney's fees, court costs, and interest accruing from the 
date on which the department provides the service to the date on 
which the department is reimbursed.

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989.                    


	§ 42.011. FUNDING.  (a) The division may receive and use 
gifts to carry out this chapter.
	(b)  The board may comply with any requirements necessary to 
obtain federal funds in the maximum amount and most advantageous 
proportions possible to carry out this chapter.
	(c)  The comptroller may receive all money appropriated by 
congress and allotted to this state for carrying out this chapter or 
agreements or plans authorized by this chapter.

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989.  Amended 
by Acts 1997, 75th Leg., ch. 1423, § 10.01, eff. Sept. 1, 1997.


	§ 42.012. CONTRACTS.  (a) The division may enter into 
contracts and agreements with persons, colleges, universities, 
associations, corporations, municipalities, and other units of 
government as necessary to carry out this chapter.
	(b)  A contract may provide for payment by the state, within 
the limits of funds available, for material, equipment, or 
services.

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989.                    


	§ 42.013. COOPERATION.  (a) The division may cooperate 
with private or public agencies to facilitate the availability of 
adequate care for all citizens with chronic kidney disease.
	(b)  The board shall make agreements, arrangements, or plans 
to cooperate with the federal government in carrying out the 
purposes of this chapter or of any federal statute or rule relating 
to the prevention, care, or treatment of kidney disease or the care, 
treatment, or rehabilitation of persons with kidney disease.  The 
board may adopt rules and methods of administration found by the 
federal government to be necessary for the proper and efficient 
operation of the agreements, arrangements, or plans.
	(c)  The division may enter into reciprocal agreements with 
other states.    

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989.                    


	§ 42.014. SCIENTIFIC INVESTIGATIONS.  (a) The division 
may develop and administer scientific investigations into the 
cause, prevention, methods of treatment, and cure of kidney 
disease, including research into kidney transplantation.
	(b)  The division may develop techniques for an effective 
method of mass testing to detect kidney disease and urinary tract 
infections.

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989.                    


	§ 42.015. EDUCATIONAL PROGRAMS.  (a) The division may 
institute, carry on, and supervise educational programs for the 
public and health providers, including physicians, hospitals, and 
public health departments, concerning chronic kidney disease, 
including prevention and methods of care and treatment.
	(b)  The division may use existing public or private programs 
or groups for the educational programs.

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989.                    


	§ 42.016. REPORTS.  The board shall report to the 
governor and the legislature not later than February 1 of each year 
concerning its findings, progress, and activities under this 
chapter and the state's total need in the field of kidney health 
care.

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989.                    


	§ 42.017. INSURANCE PREMIUMS.  The board may provide for 
payment of the premiums required to maintain coverage under Title 
XVIII of the Social Security Act (42 U.S.C. Section 1395 et seq.) 
for certain classes of persons with end stage renal disease, in 
individually considered instances according to criteria 
established by board rules.

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989.                    


	§ 42.018. FREEDOM OF SELECTION.  The freedom of an 
eligible person to select a treating physician, a treatment 
facility, or a treatment modality is not limited by Section 42.009 
if the physician, facility, or modality is approved by the board as 
required by this chapter.

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989.