AN ACT

relating to the regulation of abortion procedures, providers, and

facilities; providing penalties.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. (a) The findings indicate that:

(1) substantial medical evidence recognizes that an

unborn child is capable of experiencing pain by not later than 20

weeks after fertilization;

(2) the state has a compelling state interest in

protecting the lives of unborn children from the stage at which

substantial medical evidence indicates that these children are

capable of feeling pain;

(3) the compelling state interest in protecting the

lives of unborn children from the stage at which substantial

medical evidence indicates that an unborn child is capable of

feeling pain is intended to be separate from and independent of the

compelling state interest in protecting the lives of unborn

children from the stage of viability, and neither state interest is

intended to replace the other; and

(4) restricting elective abortions at or later than 20

weeks post-fertilization, as provided by this Act, does not impose

an undue burden or a substantial obstacle on a woman's ability to

have an abortion because:

(A) the woman has adequate time to decide whether

to have an abortion in the first 20 weeks after fertilization; and

(B) this Act does not apply to abortions that are

necessary to avert the death or substantial and irreversible

physical impairment of a major bodily function of the pregnant

woman or abortions that are performed on unborn children with

severe fetal abnormalities.

(b) The legislature intends that every application of this

statute to every individual woman shall be severable from each

other. In the unexpected event that the application of this statute

is found to impose an impermissible undue burden on any pregnant

woman or group of pregnant women, the application of the statute to

those women shall be severed from the remaining applications of the

statute that do not impose an undue burden, and those remaining

applications shall remain in force and unaffected, consistent with

Section 10 of this Act.

SECTION 2. Subchapter A, Chapter 171, Health and Safety

Code, is amended by adding Section 171.0031 to read as follows:

Sec. 171.0031. REQUIREMENTS OF PHYSICIAN; OFFENSE. (a) A

physician performing or inducing an abortion:

(1) must, on the date the abortion is performed or

induced, have active admitting privileges at a hospital that:

(A) is located not further than 30 miles from the

location at which the abortion is performed or induced; and

(B) provides obstetrical or gynecological health

care services; and

(2) shall provide the pregnant woman with:

(A) a telephone number by which the pregnant

woman may reach the physician, or other health care personnel

employed by the physician or by the facility at which the abortion

was performed or induced with access to the woman's relevant

medical records, 24 hours a day to request assistance for any

complications that arise from the performance or induction of the

abortion or ask health-related questions regarding the abortion;

and

(B) the name and telephone number of the nearest

hospital to the home of the pregnant woman at which an emergency

arising from the abortion would be treated.

(b) A physician who violates Subsection (a) commits an

offense. An offense under this section is a Class A misdemeanor

punishable by a fine only, not to exceed $4,000.

SECTION 3. Chapter 171, Health and Safety Code, is amended

by adding Subchapters C and D to read as follows:

SUBCHAPTER C. ABORTION PROHIBITED AT OR AFTER 20 WEEKS

POST-FERTILIZATION

Sec. 171.041. SHORT TITLE. This subchapter may be cited as

the Preborn Pain Act.

Sec. 171.042. DEFINITIONS. In this subchapter:

(1) "Post-fertilization age" means the age of the

unborn child as calculated from the fusion of a human spermatozoon

with a human ovum.

(2) "Severe fetal abnormality" has the meaning

assigned by Section 285.202.

Sec. 171.043. DETERMINATION OF POST-FERTILIZATION AGE

REQUIRED. Except as otherwise provided by Section 171.046, a

physician may not perform or induce or attempt to perform or induce

an abortion without, prior to the procedure:

(1) making a determination of the probable

post-fertilization age of the unborn child; or

(2) possessing and relying on a determination of the

probable post-fertilization age of the unborn child made by another

physician.

Sec. 171.044. ABORTION OF UNBORN CHILD OF 20 OR MORE WEEKS

POST-FERTILIZATION AGE PROHIBITED. Except as otherwise provided by

Section 171.046, a person may not perform or induce or attempt to

perform or induce an abortion on a woman if it has been determined,

by the physician performing, inducing, or attempting to perform or

induce the abortion or by another physician on whose determination

that physician relies, that the probable post-fertilization age of

the unborn child is 20 or more weeks.

Sec. 171.045. METHOD OF ABORTION. (a) This section

applies only to an abortion authorized under Section 171.046(a)(1)

or (2) in which:

(1) the probable post-fertilization age of the unborn

child is 20 or more weeks; or

(2) the probable post-fertilization age of the unborn

child has not been determined but could reasonably be 20 or more

weeks.

(b) Except as otherwise provided by Section 171.046(a)(3),

a physician performing an abortion under Subsection (a) shall

terminate the pregnancy in the manner that, in the physician's

reasonable medical judgment, provides the best opportunity for the

unborn child to survive.

Sec. 171.046. EXCEPTIONS. (a) The prohibitions and

requirements under Sections 171.043, 171.044, and 171.045(b) do not

apply to an abortion performed if there exists a condition that, in

the physician's reasonable medical judgment, so complicates the

medical condition of the woman that, to avert the woman's death or a

serious risk of substantial and irreversible physical impairment of

a major bodily function, other than a psychological condition, it

necessitates, as applicable:

(1) the immediate abortion of her pregnancy without

the delay necessary to determine the probable post-fertilization

age of the unborn child;

(2) the abortion of her pregnancy even though the

post-fertilization age of the unborn child is 20 or more weeks; or

(3) the use of a method of abortion other than a method

described by Section 171.045(b).

(b) A physician may not take an action authorized under

Subsection (a) if the risk of death or a substantial and

irreversible physical impairment of a major bodily function arises

from a claim or diagnosis that the woman will engage in conduct that

may result in her death or in substantial and irreversible physical

impairment of a major bodily function.

(c) The prohibitions and requirements under Sections

171.043, 171.044, and 171.045(b) do not apply to an abortion

performed on an unborn child who has a severe fetal abnormality.

Sec. 171.047. PROTECTION OF PRIVACY IN COURT PROCEEDINGS.

(a) Except as otherwise provided by this section, in a civil or

criminal proceeding or action involving an act prohibited under

this subchapter, the identity of the woman on whom an abortion has

been performed or induced or attempted to be performed or induced is

not subject to public disclosure if the woman does not give consent

to disclosure.

(b) Unless the court makes a ruling under Subsection (c) to

allow disclosure of the woman's identity, the court shall issue

orders to the parties, witnesses, and counsel and shall direct the

sealing of the record and exclusion of individuals from courtrooms

or hearing rooms to the extent necessary to protect the woman's

identity from public disclosure.

(c) A court may order the disclosure of information that is

confidential under this section if:

(1) a motion is filed with the court requesting

release of the information and a hearing on that request;

(2) notice of the hearing is served on each interested

party; and

(3) the court determines after the hearing and an in

camera review that disclosure is essential to the administration of

justice and there is no reasonable alternative to disclosure.

Sec. 171.048. CONSTRUCTION OF SUBCHAPTER. (a) This

subchapter shall be construed, as a matter of state law, to be

enforceable up to but no further than the maximum possible extent

consistent with federal constitutional requirements, even if that

construction is not readily apparent, as such constructions are

authorized only to the extent necessary to save the subchapter from

judicial invalidation. Judicial reformation of statutory language

is explicitly authorized only to the extent necessary to save the

statutory provision from invalidity.

(b) If any court determines that a provision of this

subchapter is unconstitutionally vague, the court shall interpret

the provision, as a matter of state law, to avoid the vagueness

problem and shall enforce the provision to the maximum possible

extent. If a federal court finds any provision of this subchapter

or its application to any person, group of persons, or

circumstances to be unconstitutionally vague and declines to impose

the saving construction described by this subsection, the Supreme

Court of Texas shall provide an authoritative construction of the

objectionable statutory provisions that avoids the constitutional

problems while enforcing the statute's restrictions to the maximum

possible extent, and shall agree to answer any question certified

from a federal appellate court regarding the statute.

(c) A state executive or administrative official may not

decline to enforce this subchapter, or adopt a construction of this

subchapter in a way that narrows its applicability, based on the

official's own beliefs about what the state or federal constitution

requires, unless the official is enjoined by a state or federal

court from enforcing this subchapter.

(d) This subchapter may not be construed to authorize the

prosecution of or a cause of action to be brought against a woman on

whom an abortion is performed or induced or attempted to be

performed or induced in violation of this subchapter.

SUBCHAPTER D. ABORTION-INDUCING DRUGS

Sec. 171.061. DEFINITIONS. In this subchapter:

(1) "Abortion" means the act of using, administering,

prescribing, or otherwise providing an instrument, a drug, a

medicine, or any other substance, device, or means with the intent

to terminate a clinically diagnosable pregnancy of a woman and with

knowledge that the termination by those means will, with reasonable

likelihood, cause the death of the woman's unborn child. An act is

not an abortion if the act is done with the intent to:

(A) save the life or preserve the health of an

unborn child;

(B) remove a dead, unborn child whose death was

caused by spontaneous abortion;

(C) remove an ectopic pregnancy; or

(D) treat a maternal disease or illness for which

a prescribed drug, medicine, or other substance is indicated.

(2) "Abortion-inducing drug" means a drug, a medicine,

or any other substance, including a regimen of two or more drugs,

medicines, or substances, prescribed, dispensed, or administered

with the intent of terminating a clinically diagnosable pregnancy

of a woman and with knowledge that the termination will, with

reasonable likelihood, cause the death of the woman's unborn child.

The term includes off-label use of drugs, medicines, or other

substances known to have abortion-inducing properties that are

prescribed, dispensed, or administered with the intent of causing

an abortion, including the Mifeprex regimen. The term does not

include a drug, medicine, or other substance that may be known to

cause an abortion but is prescribed, dispensed, or administered for

other medical reasons.

(3) "Final printed label" or "FPL" means the

informational document approved by the United States Food and Drug

Administration for an abortion-inducing drug that:

(A) outlines the protocol authorized by that

agency and agreed to by the drug company applying for authorization

of the drug by that agency; and

(B) delineates how a drug is to be used according

to approval by that agency.

(4) "Gestational age" means the amount of time that

has elapsed since the first day of a woman's last menstrual period.

(5) "Medical abortion" means the administration or use

of an abortion-inducing drug to induce an abortion.

(6) "Mifeprex regimen," "RU-486 regimen," or "RU-486"

means the abortion-inducing drug regimen approved by the United

States Food and Drug Administration that consists of administering

mifepristone and misoprostol.

(7) "Physician" means an individual who is licensed to

practice medicine in this state, including a medical doctor and a

doctor of osteopathic medicine.

(8) "Pregnant" means the female reproductive

condition of having an unborn child in a woman's uterus.

(9) "Unborn child" means an offspring of human beings

from conception until birth.

Sec. 171.062. ENFORCEMENT BY TEXAS MEDICAL BOARD.

Notwithstanding Section 171.005, the Texas Medical Board shall

enforce this subchapter.

Sec. 171.063. DISTRIBUTION OF ABORTION-INDUCING DRUG.

(a) A person may not knowingly give, sell, dispense, administer,

provide, or prescribe an abortion-inducing drug to a pregnant woman

for the purpose of inducing an abortion in the pregnant woman or

enabling another person to induce an abortion in the pregnant woman

unless:

(1) the person who gives, sells, dispenses,

administers, provides, or prescribes the abortion-inducing drug is

a physician; and

(2) except as otherwise provided by Subsection (b),

the provision, prescription, or administration of the

abortion-inducing drug satisfies the protocol tested and

authorized by the United States Food and Drug Administration as

outlined in the final printed label of the abortion-inducing drug.

(b) A person may provide, prescribe, or administer the

abortion-inducing drug in the dosage amount prescribed by the

clinical management guidelines defined by the American Congress of

Obstetricians and Gynecologists Practice Bulletin as those

guidelines existed on January 1, 2013.

(c) Before the physician gives, sells, dispenses,

administers, provides, or prescribes an abortion-inducing drug,

the physician must examine the pregnant woman and document, in the

woman's medical record, the gestational age and intrauterine

location of the pregnancy.

(d) The physician who gives, sells, dispenses, administers,

provides, or prescribes an abortion-inducing drug shall provide the

pregnant woman with:

(1) a copy of the final printed label of that

abortion-inducing drug; and

(2) a telephone number by which the pregnant woman may

reach the physician, or other health care personnel employed by the

physician or by the facility at which the abortion was performed

with access to the woman's relevant medical records, 24 hours a day

to request assistance for any complications that arise from the

administration or use of the drug or ask health-related questions

regarding the administration or use of the drug.

(e) The physician who gives, sells, dispenses, administers,

provides, or prescribes the abortion-inducing drug, or the

physician's agent, must schedule a follow-up visit for the woman to

occur not more than 14 days after the administration or use of the

drug. At the follow-up visit, the physician must:

(1) confirm that the pregnancy is completely

terminated; and

(2) assess the degree of bleeding.

(f) The physician who gives, sells, dispenses, administers,

provides, or prescribes the abortion-inducing drug, or the

physician's agent, shall make a reasonable effort to ensure that

the woman returns for the scheduled follow-up visit under

Subsection (e). The physician or the physician's agent shall

document a brief description of any effort made to comply with this

subsection, including the date, time, and name of the person making

the effort, in the woman's medical record.

(g) If a physician gives, sells, dispenses, administers,

provides, or prescribes an abortion-inducing drug to a pregnant

woman for the purpose of inducing an abortion as authorized by this

section and the physician knows that the woman experiences a

serious adverse event, as defined by the MedWatch Reporting System,

during or after the administration or use of the drug, the physician

shall report the event to the United States Food and Drug

Administration through the MedWatch Reporting System not later than

the third day after the date the physician learns that the event

occurred.

Sec. 171.064. ADMINISTRATIVE PENALTY. (a) The Texas

Medical Board may take disciplinary action under Chapter 164,

Occupations Code, or assess an administrative penalty under

Subchapter A, Chapter 165, Occupations Code, against a person who

violates Section 171.063.

(b) A penalty may not be assessed under this section against

a pregnant woman who receives a medical abortion.

SECTION 4. Section 245.010(a), Health and Safety Code, is

amended to read as follows:

(a) The rules must contain minimum standards to protect the

health and safety of a patient of an abortion facility and must

contain provisions requiring compliance with the requirements of

Subchapter B, Chapter 171. On and after September 1, 2014, the

minimum standards for an abortion facility must be equivalent to

the minimum standards adopted under Section 243.010 for ambulatory

surgical centers.

SECTION 5. Section 245.011(c), Health and Safety Code, is

amended to read as follows:

(c) The report must include:

(1) whether the abortion facility at which the

abortion is performed is licensed under this chapter;

(2) the patient's year of birth, race, marital status,

and state and county of residence;

(3) the type of abortion procedure;

(4) the date the abortion was performed;

(5) whether the patient survived the abortion, and if

the patient did not survive, the cause of death;

(6) the probable post-fertilization age of the unborn

child [ period of gestation ] based on the best medical judgment of

the attending physician at the time of the procedure;

(7) the date, if known, of the patient's last menstrual

cycle;

(8) the number of previous live births of the patient;

and

(9) the number of previous induced abortions of the

patient.

SECTION 6. Section 164.052(a), Occupations Code, is amended

to read as follows:

(a) A physician or an applicant for a license to practice

medicine commits a prohibited practice if that person:

(1) submits to the board a false or misleading

statement, document, or certificate in an application for a

license;

(2) presents to the board a license, certificate, or

diploma that was illegally or fraudulently obtained;

(3) commits fraud or deception in taking or passing an

examination;

(4) uses alcohol or drugs in an intemperate manner

that, in the board's opinion, could endanger a patient's life;

(5) commits unprofessional or dishonorable conduct

that is likely to deceive or defraud the public, as provided by

Section 164.053, or injure the public;

(6) uses an advertising statement that is false,

misleading, or deceptive;

(7) advertises professional superiority or the

performance of professional service in a superior manner if that

advertising is not readily subject to verification;

(8) purchases, sells, barters, or uses, or offers to

purchase, sell, barter, or use, a medical degree, license,

certificate, or diploma, or a transcript of a license, certificate,

or diploma in or incident to an application to the board for a

license to practice medicine;

(9) alters, with fraudulent intent, a medical license,

certificate, or diploma, or a transcript of a medical license,

certificate, or diploma;

(10) uses a medical license, certificate, or diploma,

or a transcript of a medical license, certificate, or diploma that

has been:

(A) fraudulently purchased or issued;

(B) counterfeited; or

(C) materially altered;

(11) impersonates or acts as proxy for another person

in an examination required by this subtitle for a medical license;

(12) engages in conduct that subverts or attempts to

subvert an examination process required by this subtitle for a

medical license;

(13) impersonates a physician or permits another to

use the person's license or certificate to practice medicine in

this state;

(14) directly or indirectly employs a person whose

license to practice medicine has been suspended, canceled, or

revoked;

(15) associates in the practice of medicine with a

person:

(A) whose license to practice medicine has been

suspended, canceled, or revoked; or

(B) who has been convicted of the unlawful

practice of medicine in this state or elsewhere;

(16) performs or procures a criminal abortion, aids or

abets in the procuring of a criminal abortion, attempts to perform

or procure a criminal abortion, or attempts to aid or abet the

performance or procurement of a criminal abortion;

(17) directly or indirectly aids or abets the practice

of medicine by a person, partnership, association, or corporation

that is not licensed to practice medicine by the board;

(18) performs an abortion on a woman who is pregnant

with a viable unborn child during the third trimester of the

pregnancy unless:

(A) the abortion is necessary to prevent the

death of the woman;

(B) the viable unborn child has a severe,

irreversible brain impairment; or

(C) the woman is diagnosed with a significant

likelihood of suffering imminent severe, irreversible brain damage

or imminent severe, irreversible paralysis; [ or ]

(19) performs an abortion on an unemancipated minor

without the written consent of the child's parent, managing

conservator, or legal guardian or without a court order, as

provided by Section 33.003 or 33.004, Family Code, authorizing the

minor to consent to the abortion, unless the physician concludes

that on the basis of the physician's good faith clinical judgment, a

condition exists that complicates the medical condition of the

pregnant minor and necessitates the immediate abortion of her

pregnancy to avert her death or to avoid a serious risk of

substantial impairment of a major bodily function and that there is

insufficient time to obtain the consent of the child's parent,

managing conservator, or legal guardian ; or

(20) performs or induces or attempts to perform or

induce an abortion in violation of Subchapter C, Chapter 171,

Health and Safety Code .

SECTION 7. Section 164.055(b), Occupations Code, is amended

to read as follows:

(b) The sanctions provided by Subsection (a) are in addition

to any other grounds for refusal to admit persons to examination

under this subtitle or to issue a license or renew a license to

practice medicine under this subtitle. The criminal penalties

provided by Section 165.152 do not apply to a violation of Section

170.002 or Subchapter C, Chapter 171 , Health and Safety Code.

SECTION 8. Effective September 1, 2014, Section 245.010(c),

Health and Safety Code, is repealed.

SECTION 9. This Act may not be construed to repeal, by

implication or otherwise, Section 164.052(a)(18), Occupations

Code, Section 170.002, Health and Safety Code, or any other

provision of Texas law regulating or restricting abortion not

specifically addressed by this Act. An abortion that complies with

this Act but violates any other law is unlawful. An abortion that

complies with another state law but violates this Act is unlawful as

provided in this Act.

SECTION 10. (a) If some or all of the provisions of this

Act are ever temporarily or permanently restrained or enjoined by

judicial order, all other provisions of Texas law regulating or

restricting abortion shall be enforced as though the restrained or

enjoined provisions had not been adopted; provided, however, that

whenever the temporary or permanent restraining order or injunction

is stayed or dissolved, or otherwise ceases to have effect, the

provisions shall have full force and effect.

(b) Mindful of Leavitt v. Jane L. , 518 U.S. 137 (1996), in

which in the context of determining the severability of a state

statute regulating abortion the United States Supreme Court held

that an explicit statement of legislative intent is controlling, it

is the intent of the legislature that every provision, section,

subsection, sentence, clause, phrase, or word in this Act, and

every application of the provisions in this Act, are severable from

each other. If any application of any provision in this Act to any

person, group of persons, or circumstances is found by a court to be

invalid, the remaining applications of that provision to all other

persons and circumstances shall be severed and may not be affected.

All constitutionally valid applications of this Act shall be

severed from any applications that a court finds to be invalid,

leaving the valid applications in force, because it is the

legislature's intent and priority that the valid applications be

allowed to stand alone. Even if a reviewing court finds a provision

of this Act to impose an undue burden in a large or substantial

fraction of relevant cases, the applications that do not present an

undue burden shall be severed from the remaining provisions and

shall remain in force, and shall be treated as if the legislature

had enacted a statute limited to the persons, group of persons, or

circumstances for which the statute's application does not present

an undue burden. The legislature further declares that it would

have passed this Act, and each provision, section, subsection,

sentence, clause, phrase, or word, and all constitutional

applications of this Act, irrespective of the fact that any

provision, section, subsection, sentence, clause, phrase, or word,

or applications of this Act, were to be declared unconstitutional

or to represent an undue burden.

(c) If Subchapter C, Chapter 171, Health and Safety Code, as

added by this Act, prohibiting abortions performed on an unborn

child 20 or more weeks after fertilization is found by any court to

be invalid or to impose an undue burden as applied to any person,

group of persons, or circumstances, the prohibition shall apply to

that person or group of persons or circumstances on the earliest

date on which the subchapter can be constitutionally applied.

(d) If any provision of this Act is found by any court to be

unconstitutionally vague, then the applications of that provision

that do not present constitutional vagueness problems shall be

severed and remain in force.

SECTION 11. (a) The executive commissioner of the Health

and Human Services Commission shall adopt the standards required by

Section 245.010, Health and Safety Code, as amended by this Act, not

later than January 1, 2014.

(b) A facility licensed under Chapter 245, Health and Safety

Code, is not required to comply with the standards adopted under

Section 245.010, Health and Safety Code, as amended by this Act,

before September 1, 2014.

SECTION 12. This Act takes effect immediately if it

receives a vote of two-thirds of all the members elected to each

house, as provided by Section 39, Article III, Texas Constitution.

If this Act does not receive the vote necessary for immediate

effect, this Act takes effect on the 91st day after the last day of

the legislative session.

______________________________ ______________________________

President of the Senate Speaker of the House

I certify that H.B. No. 2 was passed by the House on July 10,

2013, by the following vote: Yeas 96, Nays 49, 1 present, not

voting.

______________________________

Chief Clerk of the House

I certify that H.B. No. 2 was passed by the Senate on July 12,

2013, by the following vote: Yeas 19, Nays 11.

______________________________

Secretary of the Senate

APPROVED: _____________________

Date

_____________________