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).