By Rodriguez                                          H.B. No. 1748
       74R6755 DLF-D
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to selection of certain mental health care professionals
    1-3  under a managed care plan.
    1-4        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-5        SECTION 1.  Subchapter E, Chapter 21, Insurance Code, is
    1-6  amended by adding Article 21.52G to read  as follows:
    1-7        Art. 21.52G.  SELECTION OF HEALTH CARE PRACTITIONER UNDER
    1-8  MANAGED CARE PLAN
    1-9        Sec. 1.  DEFINITIONS.  In this article:
   1-10              (1)  "Managed care plan" means a health maintenance
   1-11  organization, a preferred provider organization, or another
   1-12  organization that, under a contract or other agreement entered into
   1-13  with a participant in the plan:
   1-14                    (A)  provides mental health care benefits or
   1-15  arranges for mental health care benefits to be provided to a
   1-16  participant in the plan; and
   1-17                    (B)  requires or encourages those participants to
   1-18  use participating providers designated by the plan.
   1-19              (2)  "Mental health care practitioner" means a person
   1-20  licensed to provide mental health care services in this state,
   1-21  including:
   1-22                    (A)  a person who is licensed by the Texas State
   1-23  Board of Social Worker Examiners as a licensed master social worker
   1-24  with the order of recognition of advanced clinical practitioner;
    2-1                    (B)  a person who is licensed by the Texas State
    2-2  Board of Examiners of Professional Counselors;
    2-3                    (C)  a person who is licensed to practice
    2-4  psychology by the Texas State Board of Examiners of Psychologists;
    2-5  or
    2-6                    (D)  a person who is licensed by the Texas State
    2-7  Board of Examiners of Marriage and Family Therapists.
    2-8        Sec. 2.  PROHIBITED PLAN PROVISIONS.  A managed care plan may
    2-9  not deny to a participant in the plan the right to receive the
   2-10  maximum benefit payable under the plan for mental health care
   2-11  services because the participant received those services from a
   2-12  mental health care practitioner who is not designated as a
   2-13  participating provider under the plan.
   2-14        SECTION 2.  This Act takes effect September 1, 1995, and
   2-15  applies only to an evidence of coverage under a managed health care
   2-16  plan that is delivered, issued for delivery, or renewed on or after
   2-17  January 1, 1996.  An evidence of coverage that is delivered, issued
   2-18  for delivery, or renewed before January 1, 1996, is governed by the
   2-19  law as it existed immediately before the effective date of this
   2-20  Act, and that law is continued in effect for that purpose.
   2-21        SECTION 3.  The importance of this legislation and the
   2-22  crowded condition of the calendars in both houses create an
   2-23  emergency and an imperative public necessity that the
   2-24  constitutional rule requiring bills to be read on three several
   2-25  days in each house be suspended, and this rule is hereby suspended.