By Stiles H.B. No. 1036
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the selection of podiatrists.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Subchapter E, Chapter 21, Insurance Code, is
1-5 amended by adding Article 21.52C to read as follows:
1-6 Art. 21.52C. SERVICES OF PODIATRIST
1-7 Sec. 1. DEFINITIONS. In this article:
1-8 (1) "Health Insurance policy" means an individual,
1-9 group, blanket, or franchise insurance policy, an insurance
1-10 agreement, or a group hospital service contract, including evidence
1-11 of coverage provided by a health maintenance organization under the
1-12 Texas Health Maintenance Organization Act (Chapter 20A, Vernon's
1-13 Texas Insurance Code).
1-14 (2) "Podiatric services" means any services furnished
1-15 to any person for the purpose of treating any disease, disorder,
1-16 physical injury, deformity, or ailment of the human foot.
1-17 (3) "Podiatrist" means any person who furnishes
1-18 podiatric services and who is licensed to practice podiatry by the
1-19 Texas State Board of Podiatry Examiners.
1-20 Sec. 2. SELECTION OF PODIATRIST; INTERFERENCE
1-21 PROHIBITED. No health insurance policy which is delivered,
1-22 renewed, issued for delivery, or otherwise contracted for in this
1-23 state shall:
2-1 (1) prevent any person who is a party to or
2-2 beneficiary of the health insurance policy from selecting the
2-3 podiatrist of his or her choice to furnish the podiatric services
2-4 offered by the policy or interfere with such selection provided the
2-5 podiatrist is licensed to furnish such podiatric services in this
2-6 state;
2-7 (2) deny any podiatrist the right to participate as a
2-8 contracting provider for the policy provided the podiatrist is
2-9 licensed to furnish the podiatric services offered by the policy;
2-10 or
2-11 (3) authorize any person to regulate, interfere with,
2-12 or intervene in any manner in the diagnosis or treatment of a
2-13 patient by a podiatrist for the purpose of treating any disease,
2-14 disorder, physical injury, deformity, or ailment of the human foot
2-15 provided the podiatrist practices within the scope of his or her
2-16 license.
2-17 SECTION 2. Article 20A.14, Texas Health Maintenance
2-18 Organization Act (Article 20A.14, Vernon's Texas Insurance Code),
2-19 is amended by amending Subsection (g) and adding Subsection (i) to
2-20 read as follows:
2-21 (g) No type of provider licensed or otherwise authorized to
2-22 practice in this state may be denied participation to provide
2-23 health care services which are delivered by the health maintenance
2-24 organization and which are within the scope of licensure or
2-25 authorization of the type of provider on the sole basis of type of
3-1 license or authorization. Except as provided by Subsection (i) of
3-2 this section, this <This> section may not be construed to (1)
3-3 require a health maintenance organization to utilize a particular
3-4 type of provider in its operation; (2) require that a health
3-5 maintenance organization accept each provider of a category or
3-6 type; or (3) require that health maintenance organizations contract
3-7 directly with such providers. Notwithstanding any other provision
3-8 nothing herein shall be construed to limit the health maintenance
3-9 organization's authority to set the terms and conditions under
3-10 which health care services will be rendered by providers. All
3-11 providers must comply with the terms and conditions established by
3-12 the health maintenance organization for the provision of health
3-13 services and for designation as a provider.
3-14 (i) A health maintenance organization that provides coverage
3-15 for the purpose of treating any disease, disorder, physical injury,
3-16 deformity, or ailment of the human foot through one or more
3-17 podiatrists or other health care providers shall not deny any other
3-18 qualified podiatrist the right to participate as a contracting
3-19 provider.
3-20 SECTION 3. Title 71, Revised Statutes, is amended by adding
3-21 Article 4567d to read as follows:
3-22 Art. 4567d. SELECTION OF PODIATRIST. Notwithstanding the
3-23 provisions of any other law, a health care plan whereby a
3-24 governmental entity, including the state, a county, a municipality,
3-25 a school district, a hospital district, or any other political
4-1 subdivision of a county or the state, provides benefits to its
4-2 employees or their beneficiaries in the event of accident or
4-3 sickness for the purpose of treating any disease, disorder,
4-4 physical injury, deformity, or ailment of the human foot through
4-5 the purchase of insurance or otherwise shall not:
4-6 (1) prevent the employee or beneficiary from selecting
4-7 the podiatrist of his or her choice to furnish the health care
4-8 services covered by the plan or interfere with such selection
4-9 provided the podiatrist is licensed to furnish such health care
4-10 services in this state; or
4-11 (2) deny any podiatrist the right to participate as a
4-12 contracting provider for the plan provided the podiatrist is
4-13 licensed to furnish the health care services covered by the plan.
4-14 SECTION 4. The importance of this legislation and the
4-15 crowded condition of the calendars in both houses create an
4-16 emergency and an imperative public necessity that the
4-17 constitutional rule requiring bills to be read on three several
4-18 days in each house be suspended, and this rule is hereby suspended,
4-19 and that this Act take effect and be in force from and after its
4-20 passage, and it is so enacted.