BILL ANALYSIS S.B. 1514 By: Cain (Uher) 05-17-95 Committee Report (Unamended) BACKGROUND Under the Insurance Code, no policy of accident or sickness insurance can make benefits contingent upon treatment or examination by a particular practitioner unless such limitations are specified in a provision of the policy. The Insurance Code also designates what terms shall be utilized in specifying these limitations in the policy and provides a definition of each term. However, licensed psychological associates are not separately identified under these provisions. The Insurance Code also provides that any person who is issued a health insurance policy or is a party to or beneficiary under such a policy may select specified practitioners to provide identified care. Further, insurance companies may not deny payment or discriminate in payment schedules or payment provisions between scheduled services or procedures based upon the type of practitioner who performed the service. Definitions are provided for each classification of practitioner. Again, licensed psychological associates are not separately identified practitioners under these provisions. PURPOSE S.B. 1514 includes the services of licensed psychological associates in health insurance coverage. RULEMAKING AUTHORITY It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency or institution. SECTION BY SECTION ANALYSIS SECTION 1. Amends Article 3.70-2(B), Insurance Code, to include Licensed-Psychological Associate in the terms used in designating practitioners who will and will not be recognized by a health insurer. Provides that a Licensed Psychological Associate is one licensed by the Texas State Board of Examiners of Psychologists and practicing under the supervision of a licensed psychologist. SECTION 2. Amends Art. 21.52, Section 1, Insurance Code, to define "licensed psychological associate" as a person who is licensed by the Texas State Board of Examiners of Psychologists and who practices under the supervision of a licensed psychologist. SECTION 3. Amends Art. 21.52, Section 3, Insurance Code, to include a licensed psychological associate in the list of practitioners that may be selected by a person who is issued, is party to, or is a beneficiary under any health insurance policy delivered, renewed, or issued for delivery in this state by any insurance company, association, or organization to which this article applies. Authorizes a licensed psychological associate to provide the services that fall within the scope of the licensure of that professional if those services are scheduled in that policy. Prohibits the payment or reimbursement by the insurance company, association, or organization for services or procedures in accordance with the payment schedule or the payment provisions in the policy from being denied because the services or procedures were performed by a licensed psychological associate. Prohibits any classification, differentiation, or discrimination from being in the payment schedule or the payment provisions in a health insurance policy, nor in the amount or manner of payment or reimbursement thereunder, between scheduled services or procedures when performed by a licensed psychological associate. SECTION 4. Effective date: September 1, 1995. Makes application of this Act prospective beginning January 1, 1996. SECTION 5. Emergency clause. SUMMARY OF COMMITTEE ACTION Pursuant to an announcement filed with the Journal Clerk and read by the Reading Clerk, the House Committee on Insurance met in a formal meeting on May 16, 1995 at desk #24 on the House Floor and was called to order by the Chair, Representative John Smithee. The Chair laid out S.B. 1514 and left S.B. 1514 as pending business before the Committee. In accordance with House rules, S.B. 1514 was heard in a formal meeting on May 17, 1995 at desk #24 on the House Floor. The Chair laid out S.B. 1514 as pending business before the Committee and recognized Representative Averitt who moved the Committee report S.B. 1514 as engrossed to the full House with the recommendation that it do pass, be printed, and be sent to the Committee on Local and Consent. Representative Driver seconded the motion and the motion prevailed by the following vote: AYES: (7); NAYES: (0); PNV: (0); ABSENT: (2).