73R7104 PB-F
By Johnson H.B. No. 2710
Substitute the following for H.B. No. 2710:
By Marchant C.S.H.B. No. 2710
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the operation of the Texas public school retired
1-3 employees group insurance program and to the creation of a
1-4 coordinated care network for that program.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. Section 2(10), Article 3.50-4, Insurance Code, is
1-7 amended to read as follows:
1-8 (10) "Retiree" means:
1-9 (A) a person who has retired under the Teacher
1-10 Retirement System of Texas, as provided by Subtitle C, Title 8,
1-11 Government Code, with at least 10 <or more> years of service credit
1-12 in the retirement system for actual service in Texas public schools
1-13 and who is not eligible to be covered by a plan provided under the
1-14 Texas Employees Uniform Group Insurance Benefits Act (Article
1-15 3.50-2, Vernon's Texas Insurance Code), or under the Texas State
1-16 College and University Employees Uniform Insurance Benefits Act
1-17 (Article 3.50-3, Vernon's Texas Insurance Code); or
1-18 (B) a person who has retired as a disability
1-19 retiree under Subtitle C, Title 8, Government Code, and is entitled
1-20 to receive monthly benefits from the retirement system.
1-21 SECTION 2. Section 8, Article 3.50-4, Insurance Code, is
1-22 amended by adding Subsection (l) to read as follows:
1-23 (l) The trustee may contract directly with health care
2-1 providers to provide benefits to participants in the program.
2-2 Those benefits may include dental care, eye care, hospital care,
2-3 surgical care and treatment, medical care and treatment,
2-4 obstetrical care, and prescription drugs, medicines, and prosthetic
2-5 devices.
2-6 SECTION 3. Article 3.50-4, Insurance Code, is amended by
2-7 adding Section 18C to read as follows:
2-8 Sec. 18C. COORDINATED CARE NETWORK. (a) The trustee may
2-9 take action as it determines to be necessary to implement and
2-10 administer a coordinated care network for the program. The trustee
2-11 may contract with health care practitioners or facilities and may
2-12 establish credentialing committees to evaluate the qualifications
2-13 of those practitioners and facilities.
2-14 (b) The trustee may contract with additional individuals or
2-15 entities as the trustee determines to be necessary to implement and
2-16 administer the network.
2-17 (c) The trustee, the Texas public school retired employees
2-18 group insurance program, the retired school employees group
2-19 insurance fund, and the board of trustees, officers, advisory
2-20 committee members, and employees of the trustee are not liable for
2-21 damages arising from the acts or omissions of health care providers
2-22 who are participating health care providers in the coordinated care
2-23 network established by the trustee. Those health care providers
2-24 are independent contractors and are responsible for their own acts
2-25 and omissions.
3-1 (d) The trustee, the Texas public school retired employees
3-2 group insurance program, the retired school employees group
3-3 insurance fund, or a member of a credentialing committee, or the
3-4 board of trustees, officers, advisory committee members, or
3-5 employees of the trustee are not liable for damages arising from
3-6 any act, statement, determination, recommendation made, or act
3-7 reported, without malice, in the course of the evaluation of the
3-8 qualifications of health care providers or of the patient care
3-9 rendered by those providers.
3-10 (e) Except as otherwise provided by this article, all
3-11 proceedings and records of a credentialing committee are
3-12 confidential, and all communications made to a credentialing
3-13 committee are privileged. The proceedings of a credentialing
3-14 committee are not subject to the open meetings law, Chapter 271,
3-15 Acts of the 60th Legislature, Regular Session, 1967 (Article
3-16 6252-17, Vernon's Texas Civil Statutes), and its subsequent
3-17 amendments. Except to the extent required by the constitution of
3-18 this state or the United States, the records and proceedings of a
3-19 credentialing committee and a communication made to a credentialing
3-20 committee are not subject to court subpoena.
3-21 (f) An individual, a health care provider, or a medical peer
3-22 review committee that, without malice, participates in a
3-23 credentialing committee activity or furnishes records, information,
3-24 or assistance to a credentialing committee is not liable for
3-25 damages arising from that act.
4-1 (g) Disclosure of confidential credentialing committee
4-2 information to the affected health care provider that is relevant
4-3 to the matter under review does not constitute a waiver of the
4-4 confidentiality requirements imposed under this article.
4-5 (h) A written or oral communication made to a credentialing
4-6 committee, and the records and proceedings of such a committee, may
4-7 be disclosed to appropriate state or federal agencies, national
4-8 accreditation bodies, state boards of registration or licensure, or
4-9 medical peer review committees. A disclosure under this subsection
4-10 does not constitute a waiver of the confidential and privileged
4-11 nature of the information.
4-12 (i) A credentialing committee, a person participating in a
4-13 credentialing review, a health care provider, the trustee, the
4-14 Texas public school retired employees group insurance program, or
4-15 the board of trustees, officers, advisory committee members, or
4-16 employees of the trustee that are named as defendants in any civil
4-17 action filed as a result of participation in the credentialing
4-18 process may use otherwise confidential information obtained for
4-19 legitimate internal business and professional purposes, including
4-20 use in their own defense. Use of information under this subsection
4-21 does not constitute a waiver of the confidential and privileged
4-22 nature of the information.
4-23 (j) In this section, "health care provider" means an
4-24 individual licensed as a health care practitioner, or a health care
4-25 facility.
5-1 SECTION 4. This Act takes effect September 1, 1993,
5-2 except that Section 3 takes effect immediately on passage of this
5-3 Act.
5-4 SECTION 5. The importance of this legislation and the
5-5 crowded condition of the calendars in both houses create an
5-6 emergency and an imperative public necessity that the
5-7 constitutional rule requiring bills to be read on three several
5-8 days in each house be suspended, and this rule is hereby suspended,
5-9 and that this Act take effect and be in force according to its
5-10 terms, and it is so enacted.