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.
