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AN ACT
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relating to the regulation of discount health care programs by the  | 
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Texas Department of Insurance; providing penalties. | 
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       BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | 
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       SECTION 1.  Subtitle C, Title 5, Insurance Code, is amended  | 
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by adding Chapter 562 to read as follows: | 
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CHAPTER 562. UNFAIR METHODS OF COMPETITION AND | 
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UNFAIR OR DECEPTIVE ACTS OR PRACTICES REGARDING | 
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DISCOUNT HEALTH CARE PROGRAMS | 
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SUBCHAPTER A. GENERAL PROVISIONS | 
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       Sec. 562.001.  PURPOSE.  The purpose of this chapter is to  | 
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regulate trade practices in the business of discount health care  | 
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programs by: | 
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             (1)  defining or providing for the determination of  | 
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trade practices in this state that are unfair methods of  | 
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competition or unfair or deceptive acts or practices;  and | 
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             (2)  prohibiting those unfair or deceptive trade  | 
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practices. | 
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       Sec. 562.002.  DEFINITIONS.  In this chapter: | 
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             (1)  "Advertisement, solicitation, or marketing  | 
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material" means material that is made, published, disseminated,  | 
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circulated, or placed before the public: | 
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                   (A)  in a newspaper, magazine, or other  | 
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publication; | 
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                   (B)  in a notice, circular, pamphlet, letter, or  | 
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poster; | 
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                   (C)  over a radio or television station; | 
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                   (D)  through the Internet; | 
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                   (E)  in a telephone sales script; or | 
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                   (F)  in any other manner. | 
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             (2)  "Discount health care program" means a business  | 
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arrangement or contract in which an entity, in exchange for fees,  | 
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dues, charges, or other consideration, offers its members access to  | 
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discounts on health care services provided by health care  | 
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providers.  The term does not include an insurance policy,  | 
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certificate of coverage, or other product otherwise regulated by  | 
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the department or a self-funded or self-insured employee benefit  | 
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plan. | 
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             (3)  "Discount health care program operator" means a  | 
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person who, in exchange for fees, dues, charges, or other  | 
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consideration, operates a discount health care program and  | 
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contracts with providers, provider networks, or other discount  | 
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health care program operators to offer access to health care  | 
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services at a discount and determines the charge to members. | 
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             (4)  "Health care services" includes physician care,  | 
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inpatient care, hospital surgical services, emergency services,  | 
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ambulance services, laboratory services, audiology services,  | 
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dental services, vision services, mental health services,  | 
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substance abuse services, chiropractic services, and podiatry  | 
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services, and the provision of medical equipment and supplies,  | 
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including prescription drugs. | 
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             (5)  "Marketer" means a person who sells or  | 
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distributes, or offers to sell or distribute, a discount health  | 
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care program, including a private label entity that places its name  | 
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on and markets or distributes a discount health care program, but  | 
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does not operate a discount health care program. | 
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             (6)  "Member" means a person who pays fees, dues,  | 
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charges, or other consideration for the right to participate in a  | 
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discount health care program. | 
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             (7)  "Person" means an individual, corporation,  | 
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association, partnership, or other legal entity. | 
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             (8)  "Program operator" means a discount health plan  | 
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program operator. | 
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             (9)  "Provider" means a person who is licensed or  | 
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otherwise authorized to provide health care services in this state. | 
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       Sec. 562.003.  VENUE FOR ACTIONS INVOLVING DEPARTMENT OR  | 
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COMMISSIONER.  An action under this chapter in which the department  | 
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or commissioner is a party must be brought in a district court in  | 
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Travis County. | 
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       Sec. 562.004.  APPLICABILITY.  Except as otherwise provided  | 
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by this chapter, a program operator, including the operator of a  | 
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freestanding discount health care program or a discount health care  | 
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program marketed by an insurer or a health maintenance  | 
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organization, shall comply with this chapter. | 
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       Sec. 562.005.  LIBERAL CONSTRUCTION.  This chapter shall be  | 
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liberally construed and applied to promote the underlying purposes  | 
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as provided by Section 562.001. | 
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[Sections 562.006-562.050 reserved for expansion] | 
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SUBCHAPTER B. UNFAIR METHODS OF COMPETITION AND | 
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UNFAIR OR DECEPTIVE ACTS OR PRACTICES DEFINED | 
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       Sec. 562.051.  MISREPRESENTATION REGARDING DISCOUNT HEALTH  | 
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CARE PROGRAM.  It is an unfair method of competition or an unfair or  | 
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deceptive act or practice in the business of discount health care  | 
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programs to: | 
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             (1)  misrepresent the price range of discounts offered  | 
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by the discount health care program; | 
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             (2)  misrepresent the size or location of the program's  | 
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network of providers; | 
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             (3)  misrepresent the participation of a provider in  | 
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the program's network; | 
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             (4)  suggest that a discount card offered through the  | 
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program is a federally approved Medicare prescription discount  | 
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card; | 
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             (5)  use the term "insurance," except as: | 
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                   (A)  a disclaimer of any relationship between the  | 
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discount health care program and insurance; or | 
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                   (B)  a description of an insurance product  | 
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connected with a discount health care program; or | 
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             (6)  use the term "health plan," "coverage," "copay,"  | 
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"copayments," "deductible," "preexisting conditions," "guaranteed  | 
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issue," "premium," "PPO," or "preferred provider organization," or  | 
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another similar term, in a manner that could reasonably mislead an  | 
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individual into believing that the discount health care program is  | 
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health insurance or provides coverage similar to health insurance. | 
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       Sec. 562.052.  FALSE INFORMATION AND ADVERTISING.  It is an  | 
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unfair method of competition or an unfair or deceptive act or  | 
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practice in the business of discount health care programs to make,  | 
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publish, disseminate, circulate, or place before the public or  | 
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directly or indirectly cause to be made, published, disseminated,  | 
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circulated, or placed before the public an advertisement,  | 
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solicitation, or marketing material containing an untrue,  | 
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deceptive, or misleading assertion, representation, or statement  | 
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regarding the discount health care program. | 
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       Sec. 562.053.  FAILURE TO REGISTER OR RENEW REGISTRATION;  | 
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FALSE REGISTRATION OR RENEWAL STATEMENT.  (a)  It is an unfair  | 
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method of competition or an unfair or deceptive act or practice in  | 
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the business of discount health care programs to: | 
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             (1)  fail to register or renew registration as required  | 
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under Chapter 7001; or | 
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             (2)  with intent to deceive: | 
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                   (A)  file with the department a false statement in  | 
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connection with an application for registration as a program  | 
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operator under Chapter 7001; or | 
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                   (B)  file with the department a false statement in  | 
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connection with an application for renewal of a registration as a  | 
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program operator under Chapter 7001. | 
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       (b)  The commissioner may impose on a person operating a  | 
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discount health care program for the person's failure to register  | 
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or renew registration as required under Chapter 7001 any remedy  | 
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that the commissioner is authorized to impose under Chapter 101 for  | 
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the unauthorized business of insurance. | 
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       Sec. 562.054.  MISREPRESENTATION OF DISCOUNT HEALTH CARE  | 
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PROGRAMS.  It is an unfair method of competition or an unfair or  | 
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deceptive act or practice in the business of discount health care  | 
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programs to misrepresent a discount health care program by: | 
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             (1)  making an untrue statement of material fact; | 
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             (2)  failing to state a material fact necessary to make  | 
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other statements made not misleading, considering the  | 
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circumstances under which the statements were made; | 
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             (3)  making a statement in a manner that would mislead a  | 
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reasonably prudent person to a false conclusion of a material fact; | 
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             (4)  making a material misstatement of law;  or | 
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             (5)  failing to disclose a matter required by law to be  | 
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disclosed, including failing to make an applicable disclosure  | 
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required by this code. | 
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[Sections 562.055-562.100 reserved for expansion] | 
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SUBCHAPTER C.  REGULATION OF PRACTICES | 
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       Sec. 562.101.  UNFAIR METHODS OF COMPETITION AND UNFAIR OR  | 
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DECEPTIVE ACTS OR PRACTICES PROHIBITED.  A person may not engage in  | 
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this state in a trade practice that is defined in this chapter as or  | 
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determined under this chapter to be an unfair method of competition  | 
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or an unfair or deceptive act or practice in the business of  | 
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discount health care programs. | 
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       Sec. 562.102.  PROHIBITED CONTENT OF CERTAIN DISCOUNT HEALTH  | 
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CARE PROGRAM ADVERTISING, SOLICITATION, OR MARKETING.   | 
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Notwithstanding any other provision of this code, it is unlawful  | 
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for a program operator or marketer to advertise, solicit, or market  | 
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a discount health care program containing the words "approved by  | 
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the Texas Department of Insurance" or words with a similar meaning. | 
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       Sec. 562.103.  PROGRAM OPERATOR DUTIES.  (a)  A program  | 
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operator shall: | 
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             (1)  provide a toll-free telephone number and Internet  | 
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website for members to obtain information about the discount health  | 
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care program and confirm or find providers currently participating  | 
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in the program; and | 
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             (2)  remove a provider from the discount health care  | 
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program not later than the 30th day after the date the program  | 
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operator learns that the provider is no longer participating in the  | 
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program or has lost the authority to provide services or products. | 
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       (b)  A program operator shall issue at least one membership  | 
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card to serve as proof of membership in the discount health care  | 
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program that must: | 
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             (1)  contain a clear and conspicuous statement that the  | 
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discount health care program is not insurance; and | 
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             (2)  if the discount health care program includes  | 
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discount prescription drug benefits, include: | 
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                   (A)  the name or logo of the entity administering  | 
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the prescription drug benefits; | 
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                   (B)  the international identification number  | 
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assigned by the American National Standards Institute for the  | 
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entity administering the prescription drug benefits; | 
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                   (C)  the group number applicable to the member;  | 
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and | 
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                   (D)  a telephone number to be used to contact an  | 
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appropriate person to obtain information relating to the  | 
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prescription drug benefits provided under the program. | 
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       (c)  Not later than the 15th day after the date of  | 
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enrollment, a program operator shall issue at least one set of  | 
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disclosure materials describing the terms and conditions of the  | 
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discount health care program to each household in which a person is  | 
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a member, including a statement that: | 
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             (1)  the discount health care program is not insurance,  | 
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with the word "not" capitalized; | 
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             (2)  the member is required to pay the entire amount of  | 
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the discounted rate; | 
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             (3)  the discount health care program does not  | 
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guarantee the quality of the services or products offered by  | 
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individual providers; and | 
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             (4)  if the member remains dissatisfied after  | 
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completing the discount health care program's complaint system, the  | 
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member may contact the member's state insurance department. | 
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       (d)  A program operator shall ensure that an application form  | 
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or other membership agreement: | 
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             (1)  clearly and conspicuously discloses the duration  | 
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of membership and the amount of payments the member is obligated to  | 
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make for the membership; and | 
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             (2)  contains a clear and conspicuous statement that  | 
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the discount health care program is not insurance. | 
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       (e)  A program operator shall allow any member who cancels a  | 
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membership in the discount health care program not later than the  | 
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30th day after the date the person becomes a member to receive a  | 
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refund, not later than the 30th day after the date the program  | 
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operator receives a valid cancellation notice and returned  | 
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membership card, of all periodic membership charges paid by that  | 
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member to the program operator and the amount of any one-time  | 
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enrollment fee that exceeds $50. | 
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       (f)  A program operator shall: | 
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             (1)  maintain a surety bond, payable to the department  | 
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for the use and benefit of members in a manner prescribed by the  | 
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department, in the principal amount of $50,000, except that a  | 
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program operator that is an insurer that holds a certificate of  | 
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authority under Title 6 is not required to maintain the surety bond; | 
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             (2)  maintain an agent for service of process in this  | 
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state; and | 
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             (3)  establish and operate a fair and efficient  | 
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procedure for resolution of complaints regarding the availability  | 
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of contracted discounts or services or other matters relating to  | 
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the contractual obligations of the discount health care program to  | 
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its members. | 
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       Sec. 562.104.  MARKETING OF PROGRAM.  (a)  A program operator  | 
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may market directly or contract with marketers for the distribution  | 
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of the program operator's discount health care programs. | 
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       (b)  A program operator shall enter into a written contract  | 
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with a marketer before the marketer begins marketing, promoting,  | 
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selling, or distributing the program operator's discount health  | 
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care program.  The contract must prohibit the marketer from using an  | 
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advertisement, solicitation, or other marketing material or a  | 
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discount card that has not been approved in advance and in writing  | 
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by the program operator. | 
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       (c)  A program operator must approve in writing before their  | 
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use all advertisements, solicitations, or other marketing  | 
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materials and all discount cards used by marketers to market,  | 
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promote, sell, or distribute the discount health care program. | 
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       (d)  Each advertisement, solicitation, or marketing material  | 
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of a discount health care program must clearly and conspicuously  | 
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state that the discount health care program is not insurance. | 
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       Sec. 562.105.  CONTRACT REQUIREMENTS.  (a)  A program  | 
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operator shall contract, directly or indirectly, with a provider  | 
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offering discounted health care services or products under the  | 
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discount health care program.  The written contract must contain  | 
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all of the following provisions: | 
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             (1)  a description of the discounts to be provided to a  | 
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member; | 
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             (2)  a provision prohibiting the provider from charging  | 
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a member more than the discounted rate agreed to in the written  | 
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agreement with the provider; and | 
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             (3)  a provision requiring the provider to promptly  | 
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notify the program operator if the provider no longer participates  | 
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in the program or  loses the authority to provide services or  | 
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products. | 
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       (b)  The program operator may not charge or receive from a  | 
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provider any fee or other compensation for entering into the  | 
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agreement. | 
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       (c)  If the program operator contracts with a network of  | 
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providers, the program operator shall obtain written assurance from  | 
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the network that: | 
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             (1)  the network has a written agreement with each  | 
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network provider that includes a discounted rate that is applicable  | 
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to a program operator's discount health care program and contains  | 
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all of the terms described in Subsection (a); and | 
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             (2)  the network is authorized to obligate the network  | 
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providers to provide services to members of the discount health  | 
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care program. | 
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       (d)  The program operator shall require the network to: | 
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             (1)  maintain and provide the program operator on a  | 
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monthly basis an up-to-date list of providers in the network; and | 
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             (2)  promptly remove a provider from its network if the  | 
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provider no longer participates or loses the authority to provide  | 
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services or products. | 
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       (e)  The program operator shall maintain a copy of each  | 
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written agreement the program operator has with a provider or a  | 
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network for at least two years following termination of the  | 
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agreement. | 
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       Sec. 561.106.  SUBMISSION OF MATERIALS.  If the commissioner  | 
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reasonably believes that a program operator or a marketer may not be  | 
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operating in compliance with this chapter, the commissioner by  | 
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order may require the program operator or the marketer to submit to  | 
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the commissioner any advertisement, solicitation, or marketing  | 
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material, disclosure material, discount card, agreement, or other  | 
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document requested by the commissioner. | 
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[Sections 562.107-562.150 reserved for expansion] | 
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SUBCHAPTER D. DETERMINATION OF UNFAIR METHODS OF COMPETITION AND  | 
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UNFAIR OR DECEPTIVE ACTS OR PRACTICES; ENFORCEMENT; SANCTIONS AND  | 
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PENALTIES | 
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       Sec. 562.151.  EXAMINATION AND INVESTIGATION.  The  | 
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department may examine and investigate the affairs of a person  | 
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engaged in the business of discount health care programs in this  | 
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state to determine whether the person: | 
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             (1)  has or is engaged in an unfair method of  | 
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competition or unfair or deceptive act or practice prohibited by  | 
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this chapter; or | 
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             (2)  has violated Subchapter B or C. | 
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       Sec. 562.152.  STATEMENT OF CHARGES;  NOTICE OF HEARING.  (a)   | 
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When the department has reason to believe that a person engaged in  | 
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the business of discount health care programs in this state has  | 
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engaged or is engaging in this state in an unfair method of  | 
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competition or unfair or deceptive act or practice defined by  | 
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Subchapter B or has violated Subchapter B or C and that a proceeding  | 
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by the department regarding the charges is in the interest of the  | 
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public, the department shall issue and serve on the person: | 
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             (1)  a statement of the charges;  and | 
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             (2)  a notice of the hearing on the charges, including  | 
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the time and place for the hearing. | 
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       (b)  The department may not hold the hearing before the sixth  | 
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day after the date the notice required by Subsection (a)(2) is  | 
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served. | 
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       Sec. 562.153.  HEARING.  A person against whom charges are  | 
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made under Section 562.152 is entitled at the hearing on the charges  | 
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to have an opportunity to be heard and show cause why the department  | 
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should not issue an order requiring the person to cease and desist  | 
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from: | 
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             (1)  performing the unfair method of competition or  | 
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unfair or deceptive act or practice described in the charges; or | 
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             (2)  violating Subchapter B or C. | 
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       Sec. 562.154.  HEARING PROCEDURES.  (a)  Nothing in this  | 
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chapter requires the observance of formal rules of pleading or  | 
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evidence at a hearing under this subchapter. | 
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       (b)  At a hearing under this subchapter, the department, on a  | 
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showing of good cause, shall permit any person to intervene,  | 
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appear, and be heard by counsel or in person. | 
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       Sec. 562.155.  RECORD OF HEARING.  (a)  At a hearing under  | 
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this subchapter, the department may, and at the request of a party  | 
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to the hearing shall, make a record of the proceedings and the  | 
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evidence presented at the hearing. | 
| 
 
			 | 
       (b)  If the department does not make a record and a person  | 
| 
 
			 | 
seeks judicial review of the decision made at the hearing, the  | 
| 
 
			 | 
department shall prepare a statement of the evidence and proceeding  | 
| 
 
			 | 
for use on review. | 
| 
 
			 | 
       Sec. 562.156.  COMPLIANCE WITH SUBPOENA.  (a)  If a person  | 
| 
 
			 | 
refuses to comply with a subpoena issued in connection with a  | 
| 
 
			 | 
hearing under this subchapter or refuses to testify with respect to  | 
| 
 
			 | 
a matter about which the person may be lawfully interrogated, on  | 
| 
 
			 | 
application of the department, a district court in Travis County or  | 
| 
 
			 | 
in the county in which the person resides may order the person to  | 
| 
 
			 | 
comply with the subpoena or testify. | 
| 
 
			 | 
       (b)  A court may punish as contempt a person's failure to  | 
| 
 
			 | 
obey an order under this section. | 
| 
 
			 | 
       Sec. 562.157.  DETERMINATION OF VIOLATION.  After a hearing  | 
| 
 
			 | 
under this subchapter to determine whether a person has engaged in  | 
| 
 
			 | 
an unfair method of competition or unfair or deceptive act or  | 
| 
 
			 | 
practice prohibited by this chapter, the department shall determine  | 
| 
 
			 | 
whether: | 
| 
 
			 | 
             (1)  the method of competition or the act or practice  | 
| 
 
			 | 
considered in the hearing is defined as: | 
| 
 
			 | 
                   (A)  an unfair method of competition or deceptive  | 
| 
 
			 | 
act or practice under Subchapter B; or | 
| 
 
			 | 
                   (B)  a false, misleading, or deceptive act or  | 
| 
 
			 | 
practice under Section 17.46, Business & Commerce Code; and | 
| 
 
			 | 
             (2)  the person against whom the charges were made  | 
| 
 
			 | 
engaged in the method of competition or act or practice in violation  | 
| 
 
			 | 
of: | 
| 
 
			 | 
                   (A)  this chapter; or | 
| 
 
			 | 
                   (B)  Subchapter E, Chapter 17, Business & Commerce  | 
| 
 
			 | 
Code, as specified in Section 17.46, Business & Commerce Code. | 
| 
 
			 | 
       Sec. 562.158.  CEASE AND DESIST ORDER.  On determining that a  | 
| 
 
			 | 
person committed a violation described by Section 562.157 or  | 
| 
 
			 | 
committed a violation of Subchapter B or C, the department shall: | 
| 
 
			 | 
             (1)  make written findings; and | 
| 
 
			 | 
             (2)  issue and serve on the person an order requiring  | 
| 
 
			 | 
the person to cease and desist from engaging in the method of  | 
| 
 
			 | 
competition or act or practice determined to be a violation or the  | 
| 
 
			 | 
violation of Subchapter B or C, as applicable. | 
| 
 
			 | 
       Sec. 562.159.  MODIFICATION OR SETTING ASIDE OF ORDER.  On  | 
| 
 
			 | 
the notice and in the manner the department determines proper, the  | 
| 
 
			 | 
department may modify or set aside wholly or partly a cease and  | 
| 
 
			 | 
desist order issued under Section 562.158 at any time before a  | 
| 
 
			 | 
petition appealing the order is filed in accordance with Subchapter  | 
| 
 
			 | 
D, Chapter 36. | 
| 
 
			 | 
       Sec. 562.160.  ADMINISTRATIVE PENALTY FOR VIOLATION OF CEASE  | 
| 
 
			 | 
AND DESIST ORDER.  (a)  A person who violates a cease and desist  | 
| 
 
			 | 
order issued under Section 562.158 is subject to an administrative  | 
| 
 
			 | 
penalty under Chapter 84. | 
| 
 
			 | 
       (b)  In determining whether a person has violated a cease and  | 
| 
 
			 | 
desist order, the department shall consider the maintenance of  | 
| 
 
			 | 
procedures reasonably adapted to ensure compliance with the order. | 
| 
 
			 | 
       (c)  An administrative penalty imposed under this section  | 
| 
 
			 | 
may not exceed: | 
| 
 
			 | 
             (1)  $1,000 for each violation; or | 
| 
 
			 | 
             (2)  $5,000 for all violations. | 
| 
 
			 | 
       (d)  An order of the department imposing an administrative  | 
| 
 
			 | 
penalty under this section applies only to a violation of the cease  | 
| 
 
			 | 
and desist order committed before the date the order imposing the  | 
| 
 
			 | 
penalty is issued. | 
| 
 
			 | 
       Sec. 562.161.  CIVIL PENALTY FOR VIOLATION OF CEASE AND  | 
| 
 
			 | 
DESIST ORDER.  (a)  A person who is found by a court to have violated  | 
| 
 
			 | 
a cease and desist order issued under Section 562.158 is liable to  | 
| 
 
			 | 
the state for a penalty.  The state may recover the penalty in a  | 
| 
 
			 | 
civil action. | 
| 
 
			 | 
       (b)  The penalty may not exceed $50 unless the court finds  | 
| 
 
			 | 
the violation to be wilful, in which case the penalty may not exceed  | 
| 
 
			 | 
$500. | 
| 
 
			 | 
[Sections 562.162-562.200 reserved for expansion] | 
| 
 
			 | 
SUBCHAPTER E.  ENFORCEMENT BY ATTORNEY GENERAL | 
| 
 
			 | 
       Sec. 562.201.  INJUNCTIVE RELIEF.  (a)  The attorney general  | 
| 
 
			 | 
may bring an action under this section if the attorney general has  | 
| 
 
			 | 
reason to believe that: | 
| 
 
			 | 
             (1)  a person engaged in the business of discount  | 
| 
 
			 | 
health care programs in this state is engaging in, has engaged in,  | 
| 
 
			 | 
or is about to engage in an act or practice defined as unlawful  | 
| 
 
			 | 
under: | 
| 
 
			 | 
                   (A)  this chapter; or | 
| 
 
			 | 
                   (B)  Section 17.46, Business & Commerce Code; and | 
| 
 
			 | 
             (2)  the action is in the public interest. | 
| 
 
			 | 
       (b)  The attorney general may bring the action in the name of  | 
| 
 
			 | 
the state to restrain by temporary or permanent injunction the  | 
| 
 
			 | 
person's use of the method, act, or practice. | 
| 
 
			 | 
       Sec. 562.202.  VENUE FOR INJUNCTIVE ACTION.  An action for an  | 
| 
 
			 | 
injunction under this subchapter may be commenced in a district  | 
| 
 
			 | 
court in: | 
| 
 
			 | 
             (1)  the county in which the person against whom the  | 
| 
 
			 | 
action is brought: | 
| 
 
			 | 
                   (A)  resides; | 
| 
 
			 | 
                   (B)  has the person's principal place of business;  | 
| 
 
			 | 
or | 
| 
 
			 | 
                   (C)  is engaging in business; | 
| 
 
			 | 
             (2)  the county in which the transaction or a  | 
| 
 
			 | 
substantial portion of the transaction occurred; or | 
| 
 
			 | 
             (3)  Travis County. | 
| 
 
			 | 
       Sec. 562.203.  ISSUANCE OF INJUNCTION.  (a)  The court may  | 
| 
 
			 | 
issue an appropriate temporary or permanent injunction. | 
| 
 
			 | 
       (b)  The court shall issue the injunction without bond. | 
| 
 
			 | 
       Sec. 562.204.  CIVIL PENALTY.  In addition to requesting a  | 
| 
 
			 | 
temporary or permanent injunction under Section 562.201, the  | 
| 
 
			 | 
attorney general may request a civil penalty of not more than  | 
| 
 
			 | 
$20,000 for each violation on a finding by the court that the  | 
| 
 
			 | 
defendant has engaged in or is engaging in an act or practice  | 
| 
 
			 | 
defined as unlawful under this chapter or Section 17.46, Business &  | 
| 
 
			 | 
Commerce Code. | 
| 
 
			 | 
       Sec. 562.205.  COMPENSATION OR RESTORATION.  The court may  | 
| 
 
			 | 
make an additional order or judgment as necessary to compensate an  | 
| 
 
			 | 
identifiable person for actual damages or for restoration of money  | 
| 
 
			 | 
or property that may have been acquired by means of an enjoined act  | 
| 
 
			 | 
or practice. | 
| 
 
			 | 
       Sec. 562.206.  CIVIL PENALTY FOR VIOLATION OF INJUNCTION.   | 
| 
 
			 | 
(a)  A person who violates an injunction issued under this  | 
| 
 
			 | 
subchapter is liable for and shall pay to the state a civil penalty  | 
| 
 
			 | 
of not more than $10,000 for each violation. | 
| 
 
			 | 
       (b)  The attorney general may, in the name of the state,  | 
| 
 
			 | 
petition the court for recovery of the civil penalty against the  | 
| 
 
			 | 
person who violates the injunction. | 
| 
 
			 | 
       (c)  The court shall consider the maintenance of procedures  | 
| 
 
			 | 
reasonably adapted to ensure compliance with the injunction in  | 
| 
 
			 | 
determining whether a person has violated an injunction. | 
| 
 
			 | 
       (d)  The court issuing the injunction retains jurisdiction  | 
| 
 
			 | 
and the cause is continued for the purpose of assessing a civil  | 
| 
 
			 | 
penalty under this section. | 
| 
 
			 | 
       Sec. 562.207.  REMEDIES NOT EXCLUSIVE.  The remedies  | 
| 
 
			 | 
provided by this subchapter: | 
| 
 
			 | 
             (1)  are not exclusive; and | 
| 
 
			 | 
             (2)  are in addition to any other remedy or procedure  | 
| 
 
			 | 
provided by another law or at common law. | 
| 
 
			 | 
[Sections 562.208-562.250 reserved for expansion] | 
| 
 
			 | 
SUBCHAPTER F.  ASSURANCE OF VOLUNTARY COMPLIANCE | 
| 
 
			 | 
       Sec. 562.251.  ACCEPTANCE OF ASSURANCE.  (a)  In  | 
| 
 
			 | 
administering this chapter, the department may accept assurance of  | 
| 
 
			 | 
voluntary compliance from a person who is engaging in, has engaged  | 
| 
 
			 | 
in, or is about to engage in an act or practice in violation of this  | 
| 
 
			 | 
chapter or Section 17.46, Business & Commerce Code. | 
| 
 
			 | 
       (b)  The assurance must be in writing and be filed with the  | 
| 
 
			 | 
department. | 
| 
 
			 | 
       (c)  The department may condition acceptance of an assurance  | 
| 
 
			 | 
of voluntary compliance on the stipulation that the person offering  | 
| 
 
			 | 
the assurance restore to a person in interest money that may have  | 
| 
 
			 | 
been acquired by the act or practice described in Subsection (a). | 
| 
 
			 | 
       Sec. 562.252.  EFFECT OF ASSURANCE.  (a)  An assurance of  | 
| 
 
			 | 
voluntary compliance is not an admission of a prior violation of  | 
| 
 
			 | 
this chapter or Section 17.46, Business & Commerce Code. | 
| 
 
			 | 
       (b)  Unless an assurance of voluntary compliance is  | 
| 
 
			 | 
rescinded by agreement, a subsequent failure to comply with the  | 
| 
 
			 | 
assurance is prima facie evidence of a violation of this chapter or  | 
| 
 
			 | 
Section 17.46, Business & Commerce Code. | 
| 
 
			 | 
       Sec. 562.253.  REOPENING.  A matter closed by the filing of  | 
| 
 
			 | 
an assurance of voluntary compliance may be reopened at any time. | 
| 
 
			 | 
[Sections 562.254-562.300 reserved for expansion] | 
| 
 
			 | 
SUBCHAPTER G.  CONSTRUCTION OF CHAPTER WITH OTHER LAWS | 
| 
 
			 | 
       Sec. 562.301.  LIABILITY UNDER OTHER LAW.  An order of the  | 
| 
 
			 | 
department under this chapter, or an order by a court to enforce  | 
| 
 
			 | 
that order, does not relieve or absolve a person affected by either  | 
| 
 
			 | 
order from liability under another law of this state. | 
| 
 
			 | 
       Sec. 562.302.  POWERS IN ADDITION TO OTHER POWERS AUTHORIZED  | 
| 
 
			 | 
BY LAW.  The powers vested in the department and the commissioner by  | 
| 
 
			 | 
this chapter are in addition to any other powers to enforce a  | 
| 
 
			 | 
penalty, fine, or forfeiture authorized by law with respect to a  | 
| 
 
			 | 
method of competition or act or practice defined as unfair or  | 
| 
 
			 | 
deceptive. | 
| 
 
			 | 
       Sec. 562.303.  DOUBLE RECOVERY PROHIBITED.  A person may not  | 
| 
 
			 | 
recover damages and penalties for the same act or practice under  | 
| 
 
			 | 
both this chapter and another law. | 
| 
 
			 | 
       SECTION 2.  The Insurance Code is amended by adding Title 21  | 
| 
 
			 | 
to read as follows: | 
| 
 
			 | 
TITLE 21.  DISCOUNT HEALTH CARE PROGRAMS | 
| 
 
			 | 
CHAPTER 7001.  REGISTRATION OF DISCOUNT HEALTH CARE | 
| 
 
			 | 
PROGRAM OPERATORS | 
| 
 
			 | 
       Sec. 7001.001.  DEFINITIONS.  In this chapter: | 
| 
 
			 | 
             (1)  "Discount health care program" means a business  | 
| 
 
			 | 
arrangement or contract in which an entity, in exchange for fees,  | 
| 
 
			 | 
dues, charges, or other consideration, offers its members access to  | 
| 
 
			 | 
discounts on health care services provided by health care  | 
| 
 
			 | 
providers.  The term does not include an insurance policy,  | 
| 
 
			 | 
certificate of coverage, or other product otherwise regulated by  | 
| 
 
			 | 
the department or a self-funded or self-insured employee benefit  | 
| 
 
			 | 
plan. | 
| 
 
			 | 
             (2)  "Discount health care program operator" means a  | 
| 
 
			 | 
person who, in exchange for fees, dues, charges, or other  | 
| 
 
			 | 
consideration, operates a discount health care program and  | 
| 
 
			 | 
contracts with providers, provider networks, or other discount  | 
| 
 
			 | 
health care program operators to offer access to health care  | 
| 
 
			 | 
services at a discount and determines the charge to members. | 
| 
 
			 | 
             (3)  "Health care services" includes physician care,  | 
| 
 
			 | 
inpatient care, hospital surgical services, emergency services,  | 
| 
 
			 | 
ambulance services, laboratory services, audiology services,  | 
| 
 
			 | 
dental services, vision services, mental health services,  | 
| 
 
			 | 
substance abuse services, chiropractic services, and podiatry  | 
| 
 
			 | 
services, and the provision of medical equipment and supplies,  | 
| 
 
			 | 
including prescription drugs. | 
| 
 
			 | 
             (4)  "Marketer" means a person who sells or  | 
| 
 
			 | 
distributes, or offers to sell or distribute, a discount health  | 
| 
 
			 | 
care program, including a private label entity that places its name  | 
| 
 
			 | 
on and markets or distributes a discount health care program, but  | 
| 
 
			 | 
does not operate a discount health care program. | 
| 
 
			 | 
             (5)  "Member" means a person who pays fees, dues,  | 
| 
 
			 | 
charges, or other consideration for the right to participate in a  | 
| 
 
			 | 
discount health care program. | 
| 
 
			 | 
             (6)  "Program operator" means a discount health plan  | 
| 
 
			 | 
program operator. | 
| 
 
			 | 
             (7)  "Provider" means a person who is licensed or  | 
| 
 
			 | 
otherwise authorized to provide health care services in this state. | 
| 
 
			 | 
       Sec. 7001.002.  EXEMPTION.  This chapter does not apply to a  | 
| 
 
			 | 
program operator who is an insurer and who holds a certificate of  | 
| 
 
			 | 
authority under Title 6. | 
| 
 
			 | 
       Sec. 7001.003.  RULES.  The commissioner shall adopt rules  | 
| 
 
			 | 
in the manner prescribed by Subchapter A, Chapter 36, as necessary  | 
| 
 
			 | 
to implement this chapter. | 
| 
 
			 | 
       Sec. 7001.004.  REGISTRATION REQUIRED.  A discount health  | 
| 
 
			 | 
care program operator may not offer a discount health care program  | 
| 
 
			 | 
in this state unless the program operator is registered with the  | 
| 
 
			 | 
department. | 
| 
 
			 | 
       Sec. 7001.005.  APPLICATION FOR REGISTRATION AND RENEWAL OF  | 
| 
 
			 | 
REGISTRATION.  (a)  An applicant for registration under this  | 
| 
 
			 | 
chapter or an applicant for renewal of registration under this  | 
| 
 
			 | 
chapter whose information has changed shall submit: | 
| 
 
			 | 
             (1)  a completed registration application on the form  | 
| 
 
			 | 
prescribed by the department indicating the program operator's  | 
| 
 
			 | 
name, physical address, and mailing address and its agent for  | 
| 
 
			 | 
service of process; | 
| 
 
			 | 
             (2)  a list of names, addresses, official positions,  | 
| 
 
			 | 
and biographical information of: | 
| 
 
			 | 
                   (A)  the individuals responsible for conducting  | 
| 
 
			 | 
the program operator's affairs, including: | 
| 
 
			 | 
                         (i)  each member of the board of directors,  | 
| 
 
			 | 
board of trustees, executive committee, or other governing board or  | 
| 
 
			 | 
committee; | 
| 
 
			 | 
                         (ii)  the officers of the program operator;  | 
| 
 
			 | 
and | 
| 
 
			 | 
                         (iii)  any contracted management company  | 
| 
 
			 | 
personnel; and | 
| 
 
			 | 
                   (B)  any person owning or having the right to  | 
| 
 
			 | 
acquire 10 percent or more of the voting securities of the program  | 
| 
 
			 | 
operator; | 
| 
 
			 | 
             (3)  a statement generally describing the applicant,  | 
| 
 
			 | 
its facilities and personnel, and the health care services or  | 
| 
 
			 | 
products for which a discount will be made available under its  | 
| 
 
			 | 
discount health care programs; | 
| 
 
			 | 
             (4)  a list of the marketers authorized to sell or  | 
| 
 
			 | 
distribute the program operator's programs under the program  | 
| 
 
			 | 
operator's name, a list of the marketing entities authorized to  | 
| 
 
			 | 
private label the program operator's programs, and other  | 
| 
 
			 | 
information about the marketers and marketing entities considered  | 
| 
 
			 | 
necessary by the commissioner; and | 
| 
 
			 | 
             (5)  a copy of the form of all contracts made or to be  | 
| 
 
			 | 
made between the program operator and any providers or provider  | 
| 
 
			 | 
networks regarding the provision of health care services or  | 
| 
 
			 | 
products to members. | 
| 
 
			 | 
       (b)  After the initial registration, if the form of a  | 
| 
 
			 | 
contract described by Subsection (a)(5) changes, the program  | 
| 
 
			 | 
operator must file the modified contract form with the department  | 
| 
 
			 | 
before it may be used. | 
| 
 
			 | 
       (c)  As part of the registration required under Subsection  | 
| 
 
			 | 
(a), and annually thereafter, the program operator shall certify in  | 
| 
 
			 | 
writing to the department that its programs comply with the  | 
| 
 
			 | 
requirements of this chapter and Chapter 562. | 
| 
 
			 | 
       Sec. 7001.006.  FEES.  A discount health care program  | 
| 
 
			 | 
operator shall pay the department an initial registration fee of  | 
| 
 
			 | 
$1,000 and an annual renewal fee in the amount set by the  | 
| 
 
			 | 
commissioner not to exceed $500. | 
| 
 
			 | 
       Sec. 7001.007.  DEPOSIT IN OPERATING ACCOUNT. All fees  | 
| 
 
			 | 
collected by the department under this chapter shall be deposited  | 
| 
 
			 | 
to the credit of the Texas Department of Insurance operating  | 
| 
 
			 | 
account. | 
| 
 
			 | 
       Sec. 7001.008.  CRIMINAL BACKGROUND CHECK.  The department  | 
| 
 
			 | 
may conduct a criminal background check on: | 
| 
 
			 | 
             (1)  the individuals responsible for conducting the  | 
| 
 
			 | 
program operator's affairs; | 
| 
 
			 | 
             (2)  each member of the board of directors, board of  | 
| 
 
			 | 
trustees, executive committee, or other governing board or  | 
| 
 
			 | 
committee; | 
| 
 
			 | 
             (3)  the officers of the program operator; | 
| 
 
			 | 
             (4)  any contracted management company personnel; and | 
| 
 
			 | 
             (5)  any person owning or having the right to acquire 10  | 
| 
 
			 | 
percent or more of the voting securities of the program operator. | 
| 
 
			 | 
       Sec. 7001.009.  ENFORCEMENT.  (a)  The department may deny a  | 
| 
 
			 | 
registration application or take any action authorized under  | 
| 
 
			 | 
Chapters 82, 83, and 84 if the department determines that the  | 
| 
 
			 | 
applicant or registered discount health care program operator,  | 
| 
 
			 | 
individually or through an officer, director, or shareholder: | 
| 
 
			 | 
             (1)  has wilfully violated a provision of this code or  | 
| 
 
			 | 
an order or rule of the commissioner; | 
| 
 
			 | 
             (2)  has intentionally made a material misstatement in  | 
| 
 
			 | 
the registration application; | 
| 
 
			 | 
             (3)  has obtained or attempted to obtain a registration  | 
| 
 
			 | 
by fraud or misrepresentation; | 
| 
 
			 | 
             (4)  has misappropriated, converted to the applicant's  | 
| 
 
			 | 
or registration holder's own use, or illegally withheld money  | 
| 
 
			 | 
belonging to a member of a discount health care program; | 
| 
 
			 | 
             (5)  has engaged in fraudulent or dishonest acts or  | 
| 
 
			 | 
practices; or | 
| 
 
			 | 
             (6)  has been convicted of a felony. | 
| 
 
			 | 
       (b)  Chapter 2001, Government Code, applies to an action  | 
| 
 
			 | 
taken under this section. | 
| 
 
			 | 
       SECTION 3.  Chapter 76, Health and Safety Code, is repealed. | 
| 
 
			 | 
       SECTION 4.  Not later than January 1, 2010, the commissioner  | 
| 
 
			 | 
of insurance shall adopt the rules and procedures necessary to  | 
| 
 
			 | 
implement Chapter 7001, Insurance Code, as added by this Act. | 
| 
 
			 | 
       SECTION 5.  (a)  Notwithstanding Section 7001.004,  | 
| 
 
			 | 
Insurance Code, as added by this Act, a person is not required to  | 
| 
 
			 | 
register under that section before April 1, 2010, except as  | 
| 
 
			 | 
provided by Subsection (b) of this section. | 
| 
 
			 | 
       (b)  A program operator that is registered with the Texas  | 
| 
 
			 | 
Department of Licensing and Regulation on January 1, 2010, as  | 
| 
 
			 | 
required by Chapter 76, Health and Safety Code, shall file an  | 
| 
 
			 | 
application for renewal of registration with the Texas Department  | 
| 
 
			 | 
of Insurance under Chapter 7001, Insurance Code, not later than  | 
| 
 
			 | 
April 1, 2010. | 
| 
 
			 | 
       SECTION 6.  (a)  Except as provided by Subsections (b) and  | 
| 
 
			 | 
(c) of this section, this Act takes effect September 1, 2009. | 
| 
 
			 | 
       (b)  Section 3 of this Act takes effect April 1, 2010. | 
| 
 
			 | 
       (c)  Subchapter E, Chapter 562, Insurance Code, as added by  | 
| 
 
			 | 
this Act, takes effect April 1, 2010. | 
|   | 
|   | 
|   | 
______________________________ | 
______________________________ | 
|   | 
   President of the Senate | 
Speaker of the House      | 
|   | 
|   | 
| 
 		
			 | 
       I certify that H.B. No. 4341 was passed by the House on May 6,  | 
| 
 		
			 | 
2009, by the following vote:  Yeas 143, Nays 0, 1 present, not  | 
| 
 		
			 | 
voting; and that the House concurred in Senate amendments to H.B.  | 
| 
 		
			 | 
No. 4341 on May 23, 2009, by the following vote:  Yeas 141, Nays 0,  | 
| 
 		
			 | 
1 present, not voting. | 
| 
 		
			 | 
 | 
| 
 		
			 | 
______________________________ | 
| 
 		
			 | 
Chief Clerk of the House    | 
|   | 
| 
 		
			 | 
       I certify that H.B. No. 4341 was passed by the Senate, with  | 
| 
 		
			 | 
amendments, on May 19, 2009, by the following vote:  Yeas 30, Nays  | 
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______________________________ | 
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Secretary of the Senate    | 
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APPROVED: __________________ | 
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                Date        | 
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         __________________ | 
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              Governor        |