(a) A center shall develop, implement, and enforce policies for the provision and coordination of treatment and services.
(b) The center is responsible for all care provided to center clients on its licensed premises.
(c) A center and the client shall have a written agreement for services. The center shall obtain an acknowledgment of receipt of the agreement. The center shall comply with the terms of the agreement. The written agreement shall include, the following:
  (1) services to be provided;
  (2) who will provide the services; and
  (3) charges for services rendered.
(d) When services are provided through a contract, a center must assure that these services are also provided in a safe and effective manner. If a center utilizes independent contractors, there shall be a written agreement between such independent contractors (i.e., per hour, per visit) and the center. The agreement shall be enforced by the center and clearly designate:
  (1) that clients are accepted for care only by the center;
  (2) the services to be provided by both parties;
  (3) the necessity to conform to the Act, this chapter, and all applicable center policies, including personnel qualifications; and
  (4) the manner in which services will be coordinated and evaluated by the center.
(e) A center shall not commit an intentional or negligent act that adversely affects the health or safety of a client.
(f) A center must ensure that its licensed health care professionals practice within the scope of their practice and within the constraints of applicable state laws and regulations governing their practice and must follow the facility's written policies and procedures.
(g) A center may accept student midwives to provide them with clinical experience.
(h) If a center has a contract or agreement with an accredited school of health care to use their center for a portion of a student's clinical experience, those students may provide care under the following conditions.
  (1) Students may be used in centers, provided the instructor gives classroom supervision and assumes responsibility for all student activities occurring within the center.
  (2) A student may administer medications only if:
    (A) on assignment as a student of their school of health care; and
    (B) the birth attendant within their licensed scope of practice is on the premises and directly supervises the administration of medication by the student.
  (3) Students shall not be considered when determining staffing needs required by the center.
(i) Balance Billing.
  (1) A center may not violate a law that prohibits the center from billing a patient who is an insured, participant, or enrollee in a managed care plan an amount greater than an applicable copayment, coinsurance, and deductible under the insured's, participant's, or enrollee's managed care plan or that imposes a requirement related to that prohibition.
  (2) A center shall comply with Senate Bill 1264, 86th Legislature, Regular Session, 2019, and with related Texas Department of Insurance rules at 28 TAC Chapter 21, Subchapter OO, §§21.4901 - 21.4904 (relating to Disclosures by Out-of-Network Providers) to the extent this subchapter applies to the center.

Source Note: The provisions of this §137.39 adopted to be effective December 2, 2007, 32 TexReg 8507; amended to be effective April 15, 2021, 46 TexReg 2422