By Delco H.B. No. 2099
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the containment of health care costs and to ensuring
1-3 the quality of the delivery of health care services; creating the
1-4 Texas Health Care Cost Containment Council; making appropriations;
1-5 creating offenses and providing penalties.
1-6 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-7 ARTICLE 1
1-8 SECTION 1.01. PURPOSE. As a result of rising health care
1-9 costs and concerns expressed by consumers, businesses, health care
1-10 providers, and payors and as a result of the study completed by the
1-11 Texas Health Policy Task Force, there is an urgent need to abate
1-12 escalating costs and to address the quality of health care delivery
1-13 for all Texans. It is the purpose of this legislation to address
1-14 these concerns.
1-15 ARTICLE 2
1-16 SECTION 2.01. Subtitle E, Health and Safety Code, is amended
1-17 by adding Chapter 108 to read as follows:
1-18 CHAPTER 108. TEXAS HEALTH CARE COST
1-19 CONTAINMENT COUNCIL
1-20 Sec. 108.001. CREATION OF COUNCIL. The Texas Health Care
1-21 Cost Containment Council is created under the commission of health.
1-22 The council shall report directly to the governor, the legislature,
1-23 and the public.
2-1 Sec. 108.002. DEFINITIONS. In this chapter:
2-2 (1) "Ambulatory service facility" means a facility
2-3 licensed in Texas, not part of a hospital, which provides medical,
2-4 diagnostic, or surgical treatment to patients not requiring
2-5 hospitalization, including ambulatory surgical facilities,
2-6 ambulatory imaging or diagnostic centers, birthing centers,
2-7 freestanding emergency rooms, and any other facilities providing
2-8 ambulatory care which charge a separate facility charge.
2-9 (2) "Charge" or "rate" means the amount billed by a
2-10 provider for specific goods or services provided to a patient prior
2-11 to any adjustment for contractual allowances.
2-12 (3) "Council" means the Texas Health Care Cost
2-13 Containment Council.
2-14 (4) "Covered services" means any health care services
2-15 or procedures connected with episodes of illness that require
2-16 either inpatient hospital care or major ambulatory service such as
2-17 surgical, medical, or major radiological procedures, including any
2-18 initial and followup outpatient services associated with the
2-19 episode of illness before, during, or after inpatient hospital care
2-20 or major ambulatory service.
2-21 (5) "Data source" means a hospital, a health care
2-22 facility, an ambulatory service facility, a physician, a licensed
2-23 health care provider, or a health maintenance organization as
2-24 defined in Section 2, Texas Health Maintenance Organization Act
2-25 (Article 20A.02, Vernon's Texas Insurance Code); a hospital,
3-1 medical, retiree, or health service plan; third-party payors or
3-2 insurers providing health or accident insurance; self-insured
3-3 employers providing health or accident coverage or benefits; health
3-4 claims paid by homeowners, auto liability insurance, worker's
3-5 compensation plans, or other benefit plans; any health and benefit
3-6 plan that provides health or accident benefits or insurance
3-7 pertaining to covered service in this state; preferred provider
3-8 organizations; health and human services agencies for those covered
3-9 services they purchase or provide through the medical assistance
3-10 program under Chapter 32, Human Resources Code; and any other payor
3-11 for covered services in this state.
3-12 (6) "Health care facility" means:
3-13 (A) a general or special hospital, whether
3-14 public or private, profit or nonprofit, as defined in Chapter 241;
3-15 (B) an ambulatory surgical center as defined in
3-16 Chapter 243;
3-17 (C) a private mental hospital as defined in
3-18 Chapter 577;
3-19 (D) a chemical dependency treatment facility as
3-20 defined in Chapter 464;
3-21 (E) a rehabilitation outpatient and inpatient
3-22 center; and
3-23 (F) hemodialysis units and kidney disease
3-24 treatment centers and any other facility designated as a health
3-25 care facility under federal law.
4-1 (7) "Health care insurer" means any person,
4-2 corporation, or other entity that offers administrative, indemnity,
4-3 or payment services for health care in exchange for a premium,
4-4 fees, charge, or other consideration under a program of health care
4-5 benefits including but not limited to an insurance company,
4-6 association, stipulated premium insurance company, or exchange
4-7 issuing health insurance policies in this state; hospital and
4-8 medical services plan corporation; group hospital service
4-9 corporation; health maintenance organization; preferred provider
4-10 organization; fraternal benefit society; beneficial society; and
4-11 third-party administrator.
4-12 (8) "Health maintenance organization" means an
4-13 organization as defined in Section 2, Texas Health Maintenance
4-14 Organization Act (Article 20A.02, Vernon's Texas Insurance Code).
4-15 (9) "High technology diagnostic or treatment center"
4-16 means a health treatment center that utilizes high technology
4-17 equipment including but not limited to magnetic resonance imaging
4-18 devices, lithotriptors, kidney dialysis machines, and appropriate
4-19 equipment for providing chemotherapy or radiation treatment.
4-20 (10) "Hospital" means an institution licensed in this
4-21 state which is a general or special hospital, private mental,
4-22 chronic disease, or other type of hospital or a substance abuse,
4-23 rehabilitation, radiation, chemotheraphy, or kidney disease
4-24 treatment center, whether profit or nonprofit, and including those
4-25 operated by an agency of state or local government.
5-1 (11) "Indigent care" means the actual costs, as
5-2 determined by the council, for the provision of appropriate health
5-3 care, on an inpatient or outpatient basis, given to individuals who
5-4 cannot pay for their care because they are above the medical
5-5 assistance eligibility levels and have no health insurance or other
5-6 financial resources which can cover their health care.
5-7 (12) "Major ambulatory surgical center" means a
5-8 facility engaged in surgical or medical procedures, including
5-9 diagnostic and therapeutic radiological procedures, commonly
5-10 performed in hospitals or ambulatory service facilities, which are
5-11 not of a type commonly performed or which cannot be safely
5-12 performed in physicians' offices and which require special
5-13 facilities such as operating rooms or suites or special equipment
5-14 such as fluoroscopic equipment or computed tomographic scanners or
5-15 a postprocedure recovery room or short-term convalescent room.
5-16 (13) "Medically indigent" or "indigent" means the
5-17 status of a person as described in the definition of indigent care.
5-18 (14) "Patient identification number" means that number
5-19 composed of numeric, alpha, or alphanumeric characters which has
5-20 been assigned by a third-party payor to identify a policyholder,
5-21 member, or subscriber.
5-22 (15) "Payment" means the payments that providers
5-23 actually accept for their services, exclusive of charity care,
5-24 rather than the charges they bill.
5-25 (16) "Payor" means any person or entity including but
6-1 not limited to health care insurers and purchasers that make direct
6-2 payments to providers for covered services.
6-3 (17) "Physician" means an individual licensed under
6-4 the laws of this state to practice medicine and surgery within the
6-5 scope of the Medical Practice Act (Article 4495b, Vernon's Texas
6-6 Civil Statutes).
6-7 (18) "Preferred provider organization" means any
6-8 arrangement between a health care insurer and providers of health
6-9 care services which specifies rates of payment to such providers
6-10 which differ from their usual and customary charges to the general
6-11 public and which encourage enrollees to receive health services
6-12 from such providers.
6-13 (19) "Provider" means a hospital, a physician, or any
6-14 licensed or certified health care provider.
6-15 (20) "Provider quality" means the extent to which a
6-16 provider renders care that, within the capabilities of modern
6-17 medicine, obtains for patients medically acceptable health outcomes
6-18 and prognoses, adjusted for patient severity, and treats patients
6-19 compassionately and responsively.
6-20 (21) "Provider service effectiveness" means the
6-21 effectiveness of services rendered by a provider, determined by
6-22 measurement of the medical outcome of patients, grouped by
6-23 severity, receiving those services.
6-24 (22) "Purchaser" means a corporation, labor
6-25 organization, and any other entity that purchases benefits which
7-1 provide covered services for their employees or members.
7-2 (23) "Raw data" or "data" means data collected by the
7-3 council under Section 108.009 in the form initially received.
7-4 (24) "Severity" means in any patient, the measurable
7-5 degree of the potential for failure of one or more vital organs.
7-6 Sec. 108.003. COUNCIL COMPOSITION AND VOTING. (a) The
7-7 council is composed of three nonvoting ex officio state agency
7-8 members and nine voting members appointed by the governor and
7-9 confirmed by the senate as follows:
7-10 (1) the commissioner of health;
7-11 (2) the commissioner of health and human services;
7-12 (3) an insurance board member or the commissioner of
7-13 insurance;
7-14 (4) two representatives of the business community,
7-15 with at least one representing small business, who are purchasers
7-16 of health care but who are not involved in the provision of health
7-17 care or health insurance;
7-18 (5) one representative from labor who is not involved
7-19 in the provision of health care or health insurance;
7-20 (6) two consumer representatives who are not involved
7-21 in the provision of health care or health insurance;
7-22 (7) one representative of the commercial insurance
7-23 carriers;
7-24 (8) two representatives of the health care provider
7-25 community; and
8-1 (9) one expert in health cost data management who is
8-2 not primarily involved in the provision of health care.
8-3 (b) The chair shall be appointed by the governor and serves
8-4 at the pleasure of the governor. Members shall annually elect a
8-5 vice-chair of the council from among the business, labor, and
8-6 consumer representatives on the council.
8-7 (c) Six voting members constitute a quorum for the
8-8 transaction of any business, and an act by the majority of the
8-9 voting members present at any meeting in which there is a quorum
8-10 shall be deemed to be an act of the council.
8-11 (d) The council shall adopt bylaws not inconsistent with
8-12 this chapter and may appoint such committees or elect such officers
8-13 subordinate to those provided for in Subsection (b) as it deems
8-14 advisable.
8-15 (e) The members of the council shall not receive a salary or
8-16 per diem allowance for serving as members of the council but shall
8-17 be reimbursed for actual and necessary expenses incurred in the
8-18 performance of their duties. The expenses may include
8-19 reimbursement of travel and living expenses while engaged in
8-20 council business.
8-21 Sec. 108.004. MEETINGS. (a) The council is subject to the
8-22 opening meetings law, Chapter 271, Acts of the 60th Legislature,
8-23 Regular Session, 1967 (Article 6252-17, Vernon's Texas Civil
8-24 Statutes).
8-25 (b) The council shall meet as often as necessary to perform
9-1 its duties under this chapter.
9-2 (c) The council shall also publish a notice of its meetings
9-3 in at least four newspapers in general circulation in the state.
9-4 Sec. 108.005. TERMS. (a) The terms of the agency members
9-5 are concurrent with their terms of office. The nine appointed
9-6 council members serve six-year terms and continue to serve until
9-7 their successors are appointed and qualify, except that, of the
9-8 members first appointed:
9-9 (1) one representative of business, one consumer
9-10 representative, and one representative of the health provider
9-11 community serve terms to expire two years from the date of initial
9-12 appointment;
9-13 (2) the representative from labor, the representative
9-14 of the commercial insurance carriers, and the expert in health cost
9-15 data management serve terms to expire four years from the date of
9-16 initial appointment; and
9-17 (3) one representative of business, one consumer
9-18 representative, and one representative of the health provider
9-19 community serve terms to expire six years from the date of initial
9-20 appointment.
9-21 (b) No appointed member shall be eligible to serve more than
9-22 two full consecutive terms of six years.
9-23 (c) A member may be removed by the appointing authority for
9-24 absence from one-half or more of the scheduled meetings in a year.
9-25 A member may be removed for just cause by the appointing authority
10-1 after recommendation by a vote of at least two-thirds of the
10-2 members of the council.
10-3 Sec. 108.006. POWERS AND DUTIES OF THE COUNCIL. (a) The
10-4 council shall protect patient confidentiality and exercise all
10-5 powers necessary and appropriate to carry out its duties.
10-6 (b) The council shall employ an executive director, legal
10-7 counsel, investigators, and other staff necessary to comply with
10-8 the provisions of this chapter and regulations promulgated
10-9 hereunder and engage professional consultants as it deems necessary
10-10 to the performance of its duties.
10-11 (c) The council shall promulgate rules and regulations
10-12 necessary to carry out its duties under this chapter.
10-13 Sec. 108.007. REVIEW POWERS. The council or the council's
10-14 representative may make any inspection of all documents and
10-15 records, used by data sources, required for purposes of compiling
10-16 data and reports. The council may compel providers to produce
10-17 accurate documents and records.
10-18 Sec. 108.008. AUTHORIZATION TO PERFORM CERTAIN DUTIES AND
10-19 FUNCTIONS. (a) The council shall develop a computerized system
10-20 for the collection, analysis, and dissemination of data.
10-21 (b) The council shall prescribe a Texas Uniform Claims and
10-22 Billing Form for all data sources and all providers which shall be
10-23 utilized and maintained by all data sources and all providers for
10-24 all services covered under this chapter.
10-25 (c) The council shall adopt and implement a methodology and
11-1 collect and disseminate data reflecting provider quality and
11-2 provider service effectiveness.
11-3 (d) The council shall make reports to the legislature and
11-4 the governor on the rate of increase in the cost of health care in
11-5 the state and the effectiveness of the council in carrying out the
11-6 legislative intent of this chapter. In addition, the council may
11-7 make recommendations on the need for further health care cost
11-8 containment legislation. The council shall also make annual
11-9 reports on the quality and effectiveness of health care and access
11-10 to health care for all citizens of the state.
11-11 (e) The council shall adopt, within 180 days following
11-12 commencement of its operations as part of the Texas Uniform Claims
11-13 and Billing Form for covered services pursuant to Subsection (b)
11-14 and Section 108.009(b) a standard billing form for all providers,
11-15 which shall include, in addition to information required pursuant
11-16 to Section 108.009(c), such other information and explanations as
11-17 the council deems necessary and which itemizes all charges for
11-18 services, equipment, supplies, and medicine. Each provider shall
11-19 be required to utilize the standard billing form for covered
11-20 services within 90 days of adoption of the form by the council.
11-21 Such itemized billings shall be written in language that is
11-22 understandable to the average person and be presented to each
11-23 patient on discharge from a health care facility or provision of
11-24 physician services or within a reasonable time thereafter.
11-25 Sec. 108.009. DATA SUBMISSION AND COLLECTION. (a) The
12-1 council is authorized to collect and data sources are required to
12-2 submit on request of the council all data required in this section,
12-3 according to uniform submission formats, coding systems, and other
12-4 technical specifications necessary to render the incoming data
12-5 substantially valid, consistent, compatible, and manageable using
12-6 electronic data processing.
12-7 (b) The council shall furnish the uniform claims and billing
12-8 form format to all data sources, and the claims and billing form
12-9 shall be utilized and maintained by all data sources for all
12-10 services covered by this chapter. The Texas Uniform Claims and
12-11 Billing Form shall consist of the Uniform Hospital Billing Form
12-12 UB-82/HCFA-1450 and the HCFA-1500, or their successors, as
12-13 developed by the National Uniform Billing Committee, with
12-14 additional fields as necessary to provide all of the data set forth
12-15 in Subsections (c) and (d).
12-16 (c) For each covered service performed, the council shall be
12-17 required to collect a hospital, major ambulatory service, or health
12-18 care facility discharge data record which includes all the
12-19 following:
12-20 (1) uniform patient identifier, continuous across
12-21 multiple episodes and providers;
12-22 (2) patient's date of birth;
12-23 (3) patient's sex;
12-24 (4) patient's race and ethnicity;
12-25 (5) patient's marital status;
13-1 (6) ZIP Code number of patient's primary residence;
13-2 (7) date of admission;
13-3 (8) source of admission;
13-4 (9) type of admission;
13-5 (10) date of discharge;
13-6 (11) principal and up to four secondary diagnoses by
13-7 standard code;
13-8 (12) principal procedure by council-specified standard
13-9 code and date;
13-10 (13) up to three secondary procedures by
13-11 council-specified standard codes and dates;
13-12 (14) uniform health care facility identifier,
13-13 continuous across episodes, patients, and providers;
13-14 (15) uniform identifier of admitting physician, by
13-15 unique physician identification number established by the council,
13-16 continuous across episodes, patients, and providers;
13-17 (16) uniform identifier of consulting physicians, by
13-18 unique physician identification number established by the council,
13-19 continuous across episodes, patients, and providers;
13-20 (17) total charges of the health care facility,
13-21 segregated into major categories, including but not limited to room
13-22 and board, radiology, laboratory, operating room, drugs, medical
13-23 supplies, and other goods and services according to guidelines
13-24 specified by the council;
13-25 (18) actual payments to the health care facility,
14-1 segregated, if available, according to the categories specified in
14-2 Subdivision (17);
14-3 (19) charges of each physician or licensed provider
14-4 rendering service relating to an incident of hospitalization or
14-5 treatment in an ambulatory service facility;
14-6 (20) actual payments to each physician or licensed
14-7 provider rendering service pursuant to Subdivision (19);
14-8 (21) uniform identifier of primary payor;
14-9 (22) ZIP Code number of facility where health care
14-10 service is rendered;
14-11 (23) Medicaid provider number;
14-12 (24) indigent status;
14-13 (25) county of residence of patient;
14-14 (26) deductible;
14-15 (27) co-insurance amount;
14-16 (28) uniform identifier for payor group contract
14-17 number;
14-18 (29) patient discharge status; and
14-19 (30) data elements listed in Chapter 311.
14-20 (d) In carrying out its duty to collect data on provider
14-21 quality and provider service effectiveness under Section
14-22 108.008(c), the council shall define a methodology to measure
14-23 provider service effectiveness which may include additional data
14-24 elements to be specified by the council sufficient to carry out its
14-25 responsibilities under Section 108.008(c). The council may adopt a
15-1 nationally recognized methodology of quantifying and collecting
15-2 data on provider quality and provider service effectiveness. The
15-3 council shall include in the Texas Uniform Claims and Billing Form
15-4 a field consisting of the data elements required to provide
15-5 information on each provision of covered services sufficient to
15-6 permit analysis of provider quality and provider service
15-7 effectiveness within 180 days of commencement of its operations.
15-8 (e) Except as otherwise provided by law, all licensed and
15-9 certified providers are required to submit and the council is
15-10 authorized to collect, in accordance with submission dates and
15-11 schedules established by the council, the following additional
15-12 data, provided such data are not available to the council from
15-13 public records:
15-14 (1) audited annual financial reports of all hospitals
15-15 and health care facilities or entities providing covered services
15-16 as defined in Section 108.002;
15-17 (2) the Medicare cost report (OMB Form 2552 or
15-18 equivalent federal form) or the AG-12 form for Medical Assistance
15-19 or successor forms, whether completed or partially completed and
15-20 including the settled Medicare cost report and the certified AG-12
15-21 form;
15-22 (3) additional data, including but not limited to data
15-23 which can be used to provide the following information:
15-24 (A) the incidence of medical and surgical
15-25 procedures in the population for individual providers;
16-1 (B) status of licensure and accreditation of
16-2 hospitals and ambulatory service facilities;
16-3 (C) mortality rates for specified diagnoses and
16-4 treatments, grouped by severity, for individual providers;
16-5 (D) rates of infection for specified diagnoses
16-6 and treatments, grouped by severity, for individual providers;
16-7 (E) morbidity rates for specified diagnoses and
16-8 treatments, grouped by severity, for individual providers;
16-9 (F) readmission rates for specified diagnoses
16-10 and treatments, grouped by severity, for individual providers; and
16-11 (G) rate of incidence of postdischarge provider
16-12 care for selected diagnoses and procedures, grouped by severity,
16-13 for individual providers; and
16-14 (4) any other data the council requires to carry out
16-15 its responsibilities pursuant to Section 108.008(c).
16-16 Sec. 108.010. DATA DISSEMINATION AND PUBLICATION.
16-17 (a) Subject to the restrictions on access to council data
16-18 established under Section 108.012 and utilizing the data collected
16-19 under Section 108.009 as well as other data, records, and matters
16-20 of record available to it, the council shall prepare and issue
16-21 reports to the legislature and to the general public, according to
16-22 the provisions of this section.
16-23 (b) The council shall, for every provider within the state
16-24 and within appropriate regions and subregions within the state and
16-25 for those inpatient and outpatient services which, when ranked by
17-1 order of frequency, account for at least 75 percent of all covered
17-2 services and which, when ranked by order of total payments, account
17-3 for at least 75 percent of total payments, prepare and issue
17-4 quarterly reports that at least provide information on the
17-5 following:
17-6 (1) comparisons among all providers of payments
17-7 received, charges, population-based admission or incidence rates,
17-8 and provider service effectiveness, such comparisons to be grouped
17-9 according to diagnosis and severity and to identify each provider
17-10 by name and type or specialty;
17-11 (2) comparisons among all providers of inpatient and
17-12 outpatient charges and payments for room and board, ancillary
17-13 services, drugs, equipment and supplies, and total services, such
17-14 comparisons to be grouped according to provider quality and
17-15 provider service effectiveness and according to diagnosis and
17-16 severity and to identify each health care facility by name and
17-17 type;
17-18 (3) the incidence rate of selected medical or surgical
17-19 procedures, the provider service effectiveness, and the payments
17-20 received for those providers, identified by the name and type or
17-21 specialty, for which these elements vary significantly from the
17-22 norms for all providers; and
17-23 (4) until and unless a methodology to measure provider
17-24 quality and provider service effectiveness pursuant to Sections
17-25 108.008(c) and 108.009(c) and (d) is available to the council,
18-1 comparisons among all providers, grouped according to diagnosis,
18-2 procedure, and severity, which identify facilities by name and type
18-3 and physicians by name and specialty, of charges and payments
18-4 received, readmission rates, mortality rates, morbidity rates, and
18-5 infection rates. Following adoption of the methodology specified
18-6 in Sections 108.008(c) and 108.009(c) and (d), the council may, at
18-7 its discretion, discontinue publication of this component of the
18-8 report.
18-9 Sec. 108.011. RAW DATA REPORTS AND COMPUTER ACCESS TO
18-10 COUNCIL DATA. The council shall provide special reports derived
18-11 from raw data and a means for computer-to-computer access to its
18-12 raw data to any purchaser, pursuant to Section 108.013. The
18-13 council shall provide such reports and computer-to-computer access,
18-14 at its discretion, to other parties requesting it. The council may
18-15 charge fees to parties requesting data to offset the costs of
18-16 production of the data.
18-17 Sec. 108.012. GENERAL ACCESS TO COUNCIL DATA. (a) The
18-18 information and data received by the council shall be utilized by
18-19 the council for the benefit of the public. Subject to specific
18-20 limitations the council by rule establishes, the council shall make
18-21 determinations on requests for information in favor of access.
18-22 (b) Any person who knowingly releases council data violating
18-23 the patient confidentiality, actual payments, discount data, or
18-24 raw data safeguards established by the council to an unauthorized
18-25 person commits an offense. An unauthorized person who knowingly
19-1 receives or possesses such data commits an offense. An offense
19-2 under this subsection is punishable on conviction by a fine of
19-3 $10,000 or imprisonment for not more than five years, or both such
19-4 fine and imprisonment.
19-5 Sec. 108.013. ACCESS TO RAW COUNCIL DATA BY PURCHASERS.
19-6 (a) The council shall provide access to its raw data to
19-7 purchasers.
19-8 (b) A means to enable computer-to-computer access by any
19-9 purchaser to raw data of the council shall be developed, adopted,
19-10 and implemented by the council.
19-11 Sec. 108.014. ENFORCEMENT; PENALTY. (a) The attorney
19-12 general at the request of the council, shall administer and enforce
19-13 this chapter.
19-14 (b) Any person who fails to supply data pursuant to Section
19-15 108.009 commits an offense. An offense under this section is
19-16 punishable on conviction by a fine of $25,000 or imprisonment for
19-17 not more than five years, or both such fine and imprisonment.
19-18 (c) Failure to report on each prescribed deadline is a
19-19 separate offense and subject to penalty.
19-20 ARTICLE 3
19-21 SECTION 3.01. (a) The Texas Health Care Cost Containment
19-22 Council may accept gifts, grants, money, and contributions from any
19-23 public or private source to perform its duties under this Act.
19-24 (b) For the fiscal year ending August 31, 1994, the sum of
19-25 $2 million is appropriated from the designated account in the
20-1 general revenue fund to the Texas Health Care Cost Containment
20-2 Council to carry out its duties under this Act. Available funds
20-3 from the designated account or other gifts, grants, money, or
20-4 contributions over $2 million shall also be appropriated for the
20-5 purposes of the council.
20-6 (c) For the fiscal year ending August 31, 1995, the sum of
20-7 $2 million is appropriated from the designated account in the
20-8 general revenue fund to the Texas Health Care Cost Containment
20-9 Council to carry out its duties under this Act. Available funds
20-10 from the designated account or other gifts, grants, money, or
20-11 contributions over $2 million shall also be appropriated for the
20-12 purposes of the council.
20-13 SECTION 3.02. (a) Appointments to the Texas Health Care
20-14 Cost Containment Council shall be made by the governor as soon as
20-15 practicable after the effective date of this Act.
20-16 (b) The Texas Health Care Cost Containment Council shall
20-17 begin operations immediately following the making of the
20-18 appointments required by Subsection (a) of this section.
20-19 SECTION 3.03. This Act takes effect September 1, 1993.
20-20 SECTION 3.04. The importance of this legislation and the
20-21 crowded condition of the calendars in both houses create an
20-22 emergency and an imperative public necessity that the
20-23 constitutional rule requiring bills to be read on three several
20-24 days in each house be suspended, and this rule is hereby suspended.