By Madla                                               S.B. No. 818
       74R4607 DLF-F
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to managed care plans.
    1-3        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-4        SECTION 1.  Subchapter E, Chapter 21, Insurance Code, is
    1-5  amended by adding Article 21.52F to read as follows:
    1-6        Art. 21.52F.  MANAGED CARE PLANS
    1-7        Sec. 1.  DEFINITIONS.  In this article:
    1-8              (1)  "Managed care plan" means any health maintenance
    1-9  organization, a preferred provider organization, or another
   1-10  organization that, under a contract or other agreement entered into
   1-11  with a participant in the plan:
   1-12                    (A)  provides health care benefits, or arranges
   1-13  for health care benefits to be provided, to a participant in the
   1-14  plan; and
   1-15                    (B)  requires or encourages those participants to
   1-16  use practitioners designated by the plan.
   1-17              (2)  "Practitioner" means a pharmacist, dentist,
   1-18  optometrist, psychologist, advanced nurse practitioner, podiatrist,
   1-19  or chiropractor licensed to practice in this state.
   1-20        Sec. 2.  DUTIES OF MANAGED CARE PLAN.  A managed care plan
   1-21  shall:
   1-22              (1)  demonstrate to the department that the plan has
   1-23  access to a number of practitioners that is adequate to ensure
   1-24  that:
    2-1                    (A)  all health care services covered by the plan
    2-2  are provided in a timely manner; and
    2-3                    (B)  a participant has access to the type of
    2-4  practitioner the participant chooses;
    2-5              (2)  establish a mechanism for each practitioner who
    2-6  has contracted to provide health care services under the plan to
    2-7  comment and provide information relating to:
    2-8                    (A)  the payment of benefits for new medical
    2-9  technology and procedures;
   2-10                    (B)  utilization review criteria and procedures;
   2-11                    (C)  quality of care and credentialing criteria;
   2-12  and
   2-13                    (D)  medical management procedures; and
   2-14              (3)  provide prospective participants with information
   2-15  on the terms and conditions of the plan sufficient to enable them
   2-16  to make informed decisions about accepting the managed care system
   2-17  of health care delivery.
   2-18        Sec. 3.  PROVIDER CONTRACTS.  (a)  Any qualified practitioner
   2-19  who agrees to comply with reasonable contractual terms and
   2-20  conditions of participation may participate as a contracting
   2-21  provider for a managed care plan.  The managed care plan may not
   2-22  limit the number of participating practitioners.
   2-23        (b)  This section does not apply to a managed care plan that
   2-24  provides all medical services to participants through health care
   2-25  providers who are:
   2-26              (1)  employed by the managed care plan; or
   2-27              (2)  contractually prohibited from treating individuals
    3-1  who are not participants in the plan.
    3-2        Sec. 4.  TERMINATION OF PROVIDER CONTRACTS.  (a)  Before
    3-3  terminating a provider contract with a practitioner, the managed
    3-4  care plan shall provide the practitioner with notice, an
    3-5  opportunity for discussion, and an opportunity to enter into and
    3-6  complete a corrective action program to cure any deficiency.
    3-7        (b)  This section does not apply to termination of a provider
    3-8  contract in a case in which there is a risk of imminent harm to
    3-9  patient health or in which the practitioner's license has been
   3-10  suspended, revoked, or limited by a state regulatory agency.
   3-11        Sec. 5.  PRIOR AUTHORIZATION.  A managed care plan shall
   3-12  respond to practitioner requests for prior authorization not later
   3-13  than the 24th hour after the time the request was made and shall
   3-14  provide qualified personnel for same-day telephone responses to
   3-15  inquiries about medical necessity, including certification of
   3-16  continued length of stay.  This section does not authorize a
   3-17  managed care plan to require prior authorization for emergency
   3-18  care.
   3-19        Sec. 6.  SCOPE OF PRACTICE.  (a)  A managed care plan may not
   3-20  restrict a practitioner's scope of practice under the
   3-21  practitioner's professional license and may not require
   3-22  credentials in addition to state licensure.
   3-23        (b)  This section does not affect a hospital's right to
   3-24  credential practitioners as otherwise permitted by law.
   3-25        Sec. 7.  APPLICATION; FEES.  This article does not prohibit a
   3-26  managed care plan from requiring a practitioner to pay a reasonable
   3-27  application or other administrative fee applicable to all
    4-1  contracting providers.
    4-2        SECTION 2.  This Act takes effect September 1, 1995, and
    4-3  applies only to a contract between a practitioner and a managed
    4-4  care plan entered into on or after that date.  A contract entered
    4-5  into before the effective date of this Act is governed by the law
    4-6  as it existed immediately before that date, and that law is
    4-7  continued in effect for this purpose.
    4-8        SECTION 3.  The importance of this legislation and the
    4-9  crowded condition of the calendars in both houses create an
   4-10  emergency and an imperative public necessity that the
   4-11  constitutional rule requiring bills to be read on three several
   4-12  days in each house be suspended, and this rule is hereby suspended.