By:  Kuempel                                          H.B. No. 2464
       73R5061 DLF-F
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to the inclusion of the services of certain licensed
    1-3  hearing aid fitters and dispensers in health insurance coverage.
    1-4        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-5        SECTION 1.  Subsection (B), Section 2, Chapter 397, Acts of
    1-6  the 54th Legislature, 1955 (Article 3.70-2, Vernon's Texas
    1-7  Insurance Code), is amended to read as follows:
    1-8        (B)  No policy of accident and sickness insurance shall make
    1-9  benefits contingent upon treatment or examination by a particular
   1-10  practitioner or by particular practitioners of the healing arts
   1-11  hereinafter designated unless such policy contains a provision
   1-12  designating the practitioner or practitioners who will be
   1-13  recognized by the insurer and those who will not be recognized by
   1-14  the insurer.  Such provision may be located in the "Exceptions" or
   1-15  "Exceptions and Reductions" provisions, or elsewhere in the policy,
   1-16  or by endorsement attached to the policy, at the insurer's option.
   1-17  In designating the practitioners who will and will not be
   1-18  recognized, such provision shall use the following terms:  Doctor
   1-19  of Medicine, Doctor of Osteopathy, Doctor of Dentistry, Doctor of
   1-20  Chiropractic, Doctor of Optometry, Doctor of Podiatry, Licensed
   1-21  Audiologist, Licensed Speech-language Pathologist, Doctor in
   1-22  Psychology, Certified Social Worker--Advanced Clinical
   1-23  Practitioner, Licensed Dietitian, Licensed Professional Counselor,
   1-24  <and> Licensed Marriage and Family Therapist, and Licensed Hearing
    2-1  Aid Fitter and Dispenser.
    2-2        For purposes of this Act, such designations shall have the
    2-3  following meanings:
    2-4        Doctor of Medicine:  One licensed by the Texas State Board of
    2-5  Medical Examiners on the basis of the degree "Doctor of Medicine";
    2-6        Doctor of Osteopathy:  One licensed by the Texas State Board
    2-7  of Medical Examiners on the basis of the degree of "Doctor of
    2-8  Osteopathy";
    2-9        Doctor of Dentistry:  One licensed by the State Board of
   2-10  Dental Examiners;
   2-11        Doctor of Chiropractic:  One licensed by the Texas Board of
   2-12  Chiropractic Examiners;
   2-13        Doctor of Optometry:  One licensed by the Texas Optometry
   2-14  Board;
   2-15        Doctor of Podiatry:  One licensed by the State Board of
   2-16  Podiatry Examiners;
   2-17        Licensed Audiologist:  One with a master's or doctorate
   2-18  degree in audiology from an accredited college or university and
   2-19  who is licensed as an audiologist by the State Committee of
   2-20  Examiners for Speech-Language Pathology and Audiology <certified by
   2-21  the American Speech-language and Hearing Association>;
   2-22        Licensed Speech-language Pathologist:  One with a master's or
   2-23  doctorate degree in speech pathology or speech-language pathology
   2-24  from an accredited college or university and who is licensed as a
   2-25  speech-language pathologist by the State Committee of Examiners for
   2-26  Speech-Language Pathology and Audiology <certified by the American
   2-27  Speech-language and Hearing Association>;
    3-1        Doctor in Psychology:  One licensed by the Texas State Board
    3-2  of Examiners of Psychologists and certified as a Health Service
    3-3  Provider;
    3-4        Certified Social Worker--Advanced Clinical Practitioner:  One
    3-5  certified by the Texas Department of Human Services as a Certified
    3-6  Social Worker with the order of recognition of Advanced Clinical
    3-7  Practitioner;
    3-8        Licensed Dietitian:  One licensed by the Texas State Board of
    3-9  Examiners of Dietitians;
   3-10        Licensed Professional Counselor:  One licensed by the Texas
   3-11  State Board of Examiners of Professional Counselors; <and>
   3-12        Licensed Marriage and Family Therapist:  One licensed by the
   3-13  Texas State Board of Examiners of Marriage and Family Therapists;
   3-14  and
   3-15        Licensed Hearing Aid Fitter and Dispenser:  One licensed by
   3-16  the Texas Board of Examiners in the Fitting and Dispensing of
   3-17  Hearing Aids.
   3-18        SECTION 2.  Sections 1 and 3, Article 21.52, Insurance Code,
   3-19  as amended by Chapters 242 and 824, Acts of the 72nd Legislature,
   3-20  Regular Session, 1991, are reenacted and amended to read as
   3-21  follows:
   3-22        Sec. 1.  DEFINITIONS.  As used in this article:
   3-23              (a)  "health insurance policy" means any individual,
   3-24  group, blanket, or franchise insurance policy, insurance agreement,
   3-25  or group hospital service contract, providing benefits for medical
   3-26  or surgical expenses incurred as a result of an accident or
   3-27  sickness;
    4-1              (b)  "doctor of podiatric medicine" includes D.P.M.,
    4-2  podiatrist, doctor of surgical chiropody, D.S.C. and chiropodist;
    4-3              (c)  "doctor of optometry" includes optometrist, doctor
    4-4  of optometry, and O.D.;
    4-5              (d)  "doctor of chiropractic" means a person who is
    4-6  licensed by the Texas Board of Chiropractic Examiners to practice
    4-7  chiropractic;
    4-8              (e)  "licensed dentist" means a person who is licensed
    4-9  to practice dentistry by the State Board of Dental Examiners;
   4-10              (f)  "licensed audiologist" means a person who has
   4-11  received a master's or doctorate degree in audiology from an
   4-12  accredited college or university and is licensed as an audiologist
   4-13  by the State Committee of Examiners for Speech-Language Pathology
   4-14  and Audiology <certified by the American Speech-language and
   4-15  Hearing Association>;
   4-16              (g)  "licensed speech-language pathologist" means a
   4-17  person who has received a master's or doctorate degree in
   4-18  speech-language pathology from an accredited college or university
   4-19  and is licensed as a speech-language pathologist by the State
   4-20  Committee of Examiners for Speech-Language Pathology and Audiology
   4-21  <certified by the American Speech-language and Hearing Association
   4-22  to restore speech loss or correct a speech impairment>;
   4-23              (h)  "certified social worker--advanced clinical
   4-24  practitioner" means a person who is certified by the Texas
   4-25  Department of Human Services as a certified social worker with the
   4-26  order of recognition of advanced clinical practitioner;
   4-27              (i)  "licensed dietitian" means a person who is
    5-1  licensed by the Texas State Board of Examiners of Dietitians;
    5-2              (j)  "licensed professional counselor" means a person
    5-3  who is licensed by the Texas State Board of Examiners of
    5-4  Professional Counselors; <and>
    5-5              (k)  "psychologist" means a person licensed to practice
    5-6  psychology by the Texas State Board of Examiners of Psychologists;
    5-7              (l) <(k)>  "licensed marriage and family therapist"
    5-8  means a person who is licensed by the Texas State Board of
    5-9  Examiners of Marriage and Family Therapists; and
   5-10              (m)  "licensed hearing aid fitter and dispenser" means
   5-11  a person who is licensed by the Texas Board of Examiners in the
   5-12  Fitting and Dispensing of Hearing Aids.
   5-13        Sec. 3.  SELECTION OF PRACTITIONERS.  Any person who is
   5-14  issued, who is a party to, or who is a beneficiary under any health
   5-15  insurance policy delivered, renewed, or issued for delivery in this
   5-16  state by any insurance company, association, or organization to
   5-17  which this article applies may select a licensed doctor of
   5-18  podiatric medicine, a licensed dentist, or a doctor of chiropractic
   5-19  to perform the medical or surgical services or procedures scheduled
   5-20  in the policy which fall within the scope of the license of that
   5-21  practitioner, a licensed doctor of optometry to perform the
   5-22  services or procedures scheduled in the policy which fall within
   5-23  the scope of the license of that doctor of optometry, a licensed
   5-24  <an>  audiologist to measure hearing for the purpose of determining
   5-25  the presence or extent of a hearing loss and to provide aural
   5-26  rehabilitation services to a person with a hearing loss if those
   5-27  services or procedures are scheduled in the policy, a licensed
    6-1  speech-language pathologist to evaluate speech and language and to
    6-2  provide habilitative and rehabilitative services to restore speech
    6-3  or language loss or to correct a speech or language impairment if
    6-4  those services or procedures are scheduled in the policy, a
    6-5  certified social worker--advanced clinical practitioner to provide
    6-6  the services that fall within the scope of the license of such
    6-7  certified practitioner and which are specified as services within
    6-8  the terms of the policy of insurance, including the provision of
    6-9  direct, diagnostic, preventive, or clinical services to
   6-10  individuals, families, and groups whose functioning is threatened
   6-11  or affected by social or psychological stress or health impairment,
   6-12  if those services or procedures are scheduled in the policy, a
   6-13  licensed dietitian including a provisional licensed dietitian under
   6-14  a licensed dietitian's supervision to provide the services that
   6-15  fall within the scope of the license of that dietitian if those
   6-16  services are scheduled in the policy, a licensed professional
   6-17  counselor to provide the services that fall within the scope of the
   6-18  license of that professional if those services are scheduled in the
   6-19  policy, <or> a licensed marriage and family therapist to provide
   6-20  the services that fall within the scope of the license of that
   6-21  professional if those services are scheduled in the policy, <or> a
   6-22  psychologist to perform the services or procedures scheduled in the
   6-23  policy that fall within the scope of the license of that
   6-24  psychologist, or a licensed hearing aid fitter and dispenser to
   6-25  provide the services or procedures scheduled in the policy that
   6-26  fall within the scope of the license of that practitioner.  The
   6-27  services of a certified social worker--advanced clinical
    7-1  practitioner, licensed professional counselor, or licensed marriage
    7-2  and family therapist that are included in this Act may require a
    7-3  professional recommendation by a doctor of medicine or doctor of
    7-4  osteopathy unless the health insurance policy terms do not require
    7-5  such a recommendation.  The payment or reimbursement by the
    7-6  insurance company, association, or organization for those services
    7-7  or procedures in accordance with the payment schedule or the
    7-8  payment provisions in the policy shall not be denied because the
    7-9  same were performed by a licensed doctor of podiatric medicine, a
   7-10  licensed doctor of optometry, a licensed doctor of chiropractic, a
   7-11  licensed dentist, a licensed <an> audiologist, a licensed
   7-12  speech-language pathologist, a certified social worker--advanced
   7-13  clinical practitioner, a licensed dietitian, a licensed
   7-14  professional counselor, <or> a licensed marriage and family
   7-15  therapist, <or> a psychologist, or a licensed hearing aid fitter
   7-16  and dispenser.  There shall not be any classification,
   7-17  differentiation, or other discrimination in the payment schedule or
   7-18  the payment provisions in a health insurance policy, nor in the
   7-19  amount or manner of payment or reimbursement thereunder, between
   7-20  scheduled services or procedures when performed by a doctor of
   7-21  podiatric medicine, a doctor of optometry, a doctor of
   7-22  chiropractic, a licensed dentist, a licensed <an> audiologist, a
   7-23  licensed speech-language pathologist, a certified social
   7-24  worker--advanced clinical practitioner, a licensed dietitian, a
   7-25  licensed professional counselor, <or> a licensed marriage and
   7-26  family therapist, <or> a psychologist, or a licensed hearing aid
   7-27  fitter and dispenser which fall within the scope of his license or
    8-1  certification and the same services or procedures when performed by
    8-2  any other practitioner of the healing arts whose services or
    8-3  procedures are covered by the policy.  Any provision in a health
    8-4  insurance policy contrary to or in conflict with the provisions of
    8-5  this article shall, to the extent of the conflict, be void, but
    8-6  such invalidity shall not affect the validity of the other
    8-7  provisions of this policy.  Any presently approved policy form
    8-8  containing any provision in conflict with the requirements of this
    8-9  Act shall be brought into compliance with this Act by the use of
   8-10  riders and endorsements which have been approved by the State Board
   8-11  of Insurance or by the filing of new or revised policy forms for
   8-12  approval by the State Board of Insurance.
   8-13        SECTION 3.  This Act takes effect September 1, 1993, and
   8-14  applies only to a health insurance policy that is delivered, issued
   8-15  for delivery, or renewed on or after January 1, 1994.  A health
   8-16  insurance policy that is delivered, issued for delivery, or renewed
   8-17  before January 1, 1994, is governed by the law that existed
   8-18  immediately before the effective date of this Act, and that law is
   8-19  continued in effect for that purpose.
   8-20        SECTION 4.  The importance of this legislation and the
   8-21  crowded condition of the calendars in both houses create an
   8-22  emergency and an imperative public necessity that the
   8-23  constitutional rule requiring bills to be read on three several
   8-24  days in each house be suspended, and this rule is hereby suspended.