By: Madla S.B. No. 343
A BILL TO BE ENTITLED
AN ACT
1-1 relating to the selection of podiatrists.
1-2 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-3 SECTION 1. Subchapter E, Chapter 21, Insurance Code, is
1-4 amended by adding Article 21.52C to read as follows:
1-5 Art. 21.52C. SERVICES OF PODIATRIST
1-6 Sec. 1. DEFINITIONS. In this article:
1-7 (1) "Health Insurance policy" means an individual,
1-8 group, blanket, or franchise insurance policy, an insurance
1-9 agreement, or a group hospital service contract, including evidence
1-10 of coverage provided by a health maintenance organization under the
1-11 Texas Health Maintenance Organization Act (Chapter 20A, Vernon's
1-12 Texas Insurance Code).
1-13 (2) "Podiatric services" means any services furnished
1-14 to any person for the purpose of treating any disease, disorder,
1-15 physical injury, deformity, or ailment of the human foot.
1-16 (3) "Podiatrist" means any person who furnishes
1-17 podiatric services and who is licensed to practice podiatry by the
1-18 Texas State Board of Podiatry Examiners.
1-19 Sec. 2. SELECTION OF PODIATRIST; INTERFERENCE
1-20 PROHIBITED. No health insurance policy which is delivered,
1-21 renewed, issued for delivery, or otherwise contracted for in this
1-22 state shall:
1-23 (1) prevent any person who is a party to or
2-1 beneficiary of the health insurance policy from selecting the
2-2 podiatrist of his or her choice to furnish the podiatric services
2-3 offered by the policy or interfere with such selection provided the
2-4 podiatrist is licensed to furnish such podiatric services in this
2-5 state;
2-6 (2) deny any podiatrist the right to participate as a
2-7 contracting provider for the policy provided the podiatrist is
2-8 licensed to furnish the podiatric services offered by the policy;
2-9 or
2-10 (3) authorize any person to regulate, interfere with,
2-11 or intervene in any manner in the diagnosis or treatment of a
2-12 patient by a podiatrist for the purpose of treating any disease,
2-13 disorder, physical injury, deformity, or ailment of the human foot
2-14 provided the podiatrist practices within the scope of his or her
2-15 license.
2-16 SECTION 2. Article 20A.14, Texas Health Maintenance
2-17 Organization Act (Article 20A.14, Vernon's Texas Insurance Code),
2-18 is amended by amending Subsection (g) and adding Subsection (i) to
2-19 read as follows:
2-20 (g) No type of provider licensed or otherwise authorized to
2-21 practice in this state may be denied participation to provide
2-22 health care services which are delivered by the health maintenance
2-23 organization and which are within the scope of licensure or
2-24 authorization of the type of provider on the sole basis of type of
2-25 license or authorization. Except as provided by Subsection (i) of
3-1 this section, this <This> section may not be construed to (1)
3-2 require a health maintenance organization to utilize a particular
3-3 type of provider in its operation; (2) require that a health
3-4 maintenance organization accept each provider of a category or
3-5 type; or (3) require that health maintenance organizations contract
3-6 directly with such providers. Notwithstanding any other provision
3-7 nothing herein shall be construed to limit the health maintenance
3-8 organization's authority to set the terms and conditions under
3-9 which health care services will be rendered by providers. All
3-10 providers must comply with the terms and conditions established by
3-11 the health maintenance organization for the provision of health
3-12 services and for designation as a provider.
3-13 (i) A health maintenance organization that provides coverage
3-14 for the purpose of treating any disease, disorder, physical injury,
3-15 deformity, or ailment of the human foot through one or more
3-16 podiatrists or other health care providers shall not deny any other
3-17 qualified podiatrist the right to participate as a contracting
3-18 provider.
3-19 SECTION 3. Title 71, Revised Statutes, is amended by adding
3-20 Article 4567d to read as follows:
3-21 Art. 4567d. SELECTION OF PODIATRIST. Notwithstanding the
3-22 provisions of any other law, a health care plan whereby a
3-23 governmental entity, including the state, a county, a municipality,
3-24 a school district, a hospital district, or any other political
3-25 subdivision of a county or the state, provides benefits to its
4-1 employees or their beneficiaries in the event of accident or
4-2 sickness for the purpose of treating any disease, disorder,
4-3 physical injury, deformity, or ailment of the human foot through
4-4 the purchase of insurance or otherwise shall not:
4-5 (1) prevent the employee or beneficiary from selecting
4-6 the podiatrist of his or her choice to furnish the health care
4-7 services covered by the plan or interfere with such selection
4-8 provided the podiatrist is licensed to furnish such health care
4-9 services in this state; or
4-10 (2) deny any podiatrist the right to participate as a
4-11 contracting provider for the plan provided the podiatrist is
4-12 licensed to furnish the health care services covered by the plan.
4-13 SECTION 4. The importance of this legislation and the
4-14 crowded condition of the calendars in both houses create an
4-15 emergency and an imperative public necessity that the
4-16 constitutional rule requiring bills to be read on three several
4-17 days in each house be suspended, and this rule is hereby suspended,
4-18 and that this Act take effect and be in force from and after its
4-19 passage, and it is so enacted.