1-1 By: Patterson S.B. No. 555
1-2 (In the Senate - Filed March 2, 1993; March 3, 1993, read
1-3 first time and referred to Committee on Economic Development;
1-4 April 21, 1993, reported favorably, as amended, by the following
1-5 vote: Yeas 9, Nays 1; April 21, 1993, sent to printer.)
1-6 COMMITTEE VOTE
1-7 Yea Nay PNV Absent
1-8 Parker x
1-9 Lucio x
1-10 Ellis x
1-11 Haley x
1-12 Harris of Dallas x
1-13 Harris of Tarrant x
1-14 Leedom x
1-15 Madla x
1-16 Rosson x
1-17 Shapiro x
1-18 Wentworth x
1-19 COMMITTEE AMENDMENT NO. 1 By: Leedom
1-20 (1) Strike lines 59 through line 64 on page 1 and line 1 on
1-21 page 2 and substitute the following:
1-22 SECTION 1. Section 2, Texas Health Maintenance Organization
1-23 Act (Article 20A.02, Vernon's Texas Insurance Code), is amended by
1-24 amending Subsection (s) and adding Subsection (u) to read as
1-25 follows:
1-26 (s) "Single health care service plan" means a plan under
1-27 which any person undertakes to provide, arrange for, pay for, or
1-28 reimburse any part of the cost of a single health care service,
1-29 provided<,> that a part of the plan consists of arranging for or
1-30 the provision of the single health care service<,> as distinguished
1-31 from an indemnification against the cost of that service, on a
1-32 prepaid basis through insurance or otherwise and that no part of
1-33 that plan consists of arranging for the provision of more than one
1-34 health care need of a single specified nature. A plan that
1-35 provides only mental health services and substance abuse services
1-36 is a single health care service plan.
1-37 (u) "Prepaid" means payment is made by or on behalf of an
1-38 enrollee in advance of receiving services which results in the
1-39 elimination or reduction of the amount to be paid by the enrollee
1-40 at the time services are received by the enrollee.
1-41 (2) On page 2, line 35 insert the following between "SECTION
1-42 5" and "This":
1-43 (a) An existing organization that provides only mental
1-44 health services and substance abuse services which is required by
1-45 this Act to apply for a certificate of authority to operate as a
1-46 health maintenance organization must submit an application as
1-47 provided by the Texas Health Maintenance Organization Act (Chapter
1-48 20A, Vernon's Texas Insurance Code). Such application must be
1-49 postmarked by no later than 5:00 p.m. on December 31, 1993. An
1-50 applicant may continue to operate until the commissioner of
1-51 insurance acts on the application. If an application is denied,
1-52 the applicant shall be treated as a health maintenance organization
1-53 whose certificate of authority has been revoked.
1-54 A BILL TO BE ENTITLED
1-55 AN ACT
1-56 relating to provision of certain mental health and substance abuse
1-57 services through single service health maintenance organizations.
1-58 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-59 SECTION 1. Section 5, Texas Health Maintenance Organization
1-60 Act (Article 20A.05, Vernon's Texas Insurance Code), is amended by
1-61 adding Subsection (e) to read as follows:
1-62 (e) For purposes of issuing a certificate of authority to a
1-63 single health care service plan under this section, a plan that
1-64 provides only mental health services and substance abuse services
1-65 is a single health care service plan.
1-66 SECTION 2. Section 6, Texas Health Maintenance Organization
1-67 Act (Article 20A.06, Vernon's Texas Insurance Code), is amended by
1-68 adding Subsection (c) to read as follows:
2-1 (c) A health maintenance organization may furnish or arrange
2-2 mental health services and substance abuse services through
2-3 contract with a single service health maintenance organization.
2-4 SECTION 3. Article 3.51-14, Insurance Code, is amended by
2-5 adding Section 4 to read as follows:
2-6 Sec. 4. SINGLE SERVICE HEALTH MAINTENANCE ORGANIZATIONS;
2-7 EXCEPTION. (a) An insurer, nonprofit hospital service plan
2-8 corporation, health maintenance organization, or self-funded or
2-9 self-insured welfare or benefit plan, program, or arrangement
2-10 subject to Section 2 of this article may satisfy the requirements
2-11 of this article by offering the required coverage through a
2-12 contract with a single service health maintenance organization.
2-13 (b) An insurer, nonprofit hospital service plan corporation,
2-14 health maintenance organization, or self-funded or self-insured
2-15 welfare or benefit plan, program, or arrangement subject to Section
2-16 2 of this article is not required to comply with this article if
2-17 the required coverage is provided to the group under a contract
2-18 between the group policy holder, contract holder, employer,
2-19 multiple employer, union, association, or trustee and a single
2-20 service health maintenance organization.
2-21 SECTION 4. Section 2A, Article 3.51-9, Insurance Code, is
2-22 amended by adding Subsection (f) to read as follows:
2-23 (f) An insurer, nonprofit hospital and medical service plan
2-24 corporation, health maintenance organization, or self-funded or
2-25 self-insured plan or arrangement subject to Subsection (a) of this
2-26 section is not required to comply with this article if the required
2-27 coverage is provided to the group under a contract between the
2-28 group policy holder, contract holder, employer, or other entity
2-29 acting on behalf of the group and a single service health
2-30 maintenance organization.
2-31 SECTION 5. This Act takes effect September 1, 1993, and
2-32 applies only to an insurance policy, contract, or self-funded or
2-33 self-insured plan, program, or arrangement that is delivered,
2-34 issued for delivery, or renewed on or after January 1, 1994. An
2-35 insurance policy, contract, or self-funded or self-insured plan,
2-36 program, or arrangement that is delivered, issued for delivery, or
2-37 renewed before January 1, 1994, is governed by the law as it
2-38 existed immediately before the effective date of this Act, and
2-39 that law is continued in effect for that purpose.
2-40 SECTION 6. The importance of this legislation and the
2-41 crowded condition of the calendars in both houses create an
2-42 emergency and an imperative public necessity that the
2-43 constitutional rule requiring bills to be read on three several
2-44 days in each house be suspended, and this rule is hereby suspended.
2-45 * * * * *
2-46 Austin,
2-47 Texas
2-48 April 21, 1993
2-49 Hon. Bob Bullock
2-50 President of the Senate
2-51 Sir:
2-52 We, your Committee on Economic Development to which was referred
2-53 S.B. No. 555, have had the same under consideration, and I am
2-54 instructed to report it back to the Senate with the recommendation
2-55 that it do pass, as amended, and be printed.
2-56 Lucio,
2-57 Vice-Chairman
2-58 * * * * *
2-59 WITNESSES
2-60 FOR AGAINST ON
2-61 ___________________________________________________________________
2-62 Name: Rhonda Myron x
2-63 Representing: Texas Dept. of Insurance
2-64 City: Austin
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2-66 Name: Tom Bond x
2-67 Representing: Texas HMO Association
2-68 City: Austin
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