By:  Shapiro                                          S.B. No. 1361
                                 A BILL TO BE ENTITLED
                                        AN ACT
    1-1  relating to the definition of the terms "emergency medical care,"
    1-2  "emergency care," and "emergency services."
    1-3        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-4        SECTION 1.  Subsection (I), Section 2, Chapter 397, Acts of
    1-5  the 54th Legislature, 1955 (Article 3.70-2, Vernon's Texas
    1-6  Insurance Code), is amended to read as follows:
    1-7        (I)  An individual or group policy of accident and sickness
    1-8  insurance that provides any emergency care benefit, including
    1-9  policies issued by companies subject to Chapter 20, Insurance Code,
   1-10  delivered or issued for delivery in this state must define
   1-11  emergency care as follows:  "Emergency care" means <bona fide>
   1-12  emergency services provided:
   1-13              (1)  after the recent <sudden> onset of a medical
   1-14  condition manifesting itself by acute symptoms of sufficient
   1-15  severity, including severe pain, such that the absence of immediate
   1-16  medical attention could reasonably be expected by a prudent
   1-17  layperson to result in:
   1-18                    (a) <(1)>  placing the <patient's> health of the
   1-19  individual (or, with respect to a pregnant woman, the health of the
   1-20  woman or her unborn child) in serious jeopardy;
   1-21                    (b) <(2)>  serious impairment to bodily
   1-22  functions; or
   1-23                    (c) <(3)>  serious dysfunction of any bodily
    2-1  organ or part; or
    2-2              (2)  to a pregnant woman who is having contractions,
    2-3  and:
    2-4                    (a)  there is inadequate time to effect a safe
    2-5  transfer to another hospital before delivery; or
    2-6                    (b)  transfer may pose a threat to the health or
    2-7  safety of the woman or the unborn child.
    2-8        SECTION 2.  Subsection (t), Section 2, Texas Health
    2-9  Maintenance Organization Act (Article 20A.02, Vernon's Texas
   2-10  Insurance Code), is amended to read as follows:
   2-11        (t)  "Emergency care" means <bona fide> emergency services
   2-12  provided:
   2-13              (1)  after the recent <sudden> onset of a medical
   2-14  condition manifesting itself by acute symptoms of sufficient
   2-15  severity, including severe pain, such that the absence of immediate
   2-16  medical attention could reasonably be expected by a prudent
   2-17  layperson to result in:
   2-18                    (A) <(1)>  placing the <patient's> health of the
   2-19  individual (or, with respect to a pregnant woman, the health of the
   2-20  woman or her unborn child) in serious jeopardy;
   2-21                    (B) <(2)>  serious impairment to bodily
   2-22  functions; or
   2-23                    (C) <(3)>  serious dysfunction of any bodily
   2-24  organ or part; or
   2-25              (2)  to a pregnant woman who is having contractions,
    3-1  and:
    3-2                    (A)  there is inadequate time to effect a safe
    3-3  transfer to another hospital before delivery; or
    3-4                    (B)  transfer may pose a threat to the health or
    3-5  safety of the woman or the unborn child.
    3-6        SECTION 3.  Section 311.021, Health and Safety Code, is
    3-7  amended to read as follows:
    3-8        Sec. 311.021.  DEFINITION.  In this subchapter, "emergency
    3-9  services" means services that are usually and customarily available
   3-10  at a hospital and that must be provided:
   3-11              (1)  after the recent onset of a medical condition
   3-12  manifesting itself by acute symptoms of sufficient severity,
   3-13  including severe pain, such that the absence of immediate medical
   3-14  attention could reasonably be expected to result in:
   3-15                    (A)  placing the health of the individual (or,
   3-16  with respect to a pregnant woman, the health of the woman or her
   3-17  unborn child) in serious jeopardy;
   3-18                    (B)  serious impairment to bodily functions; or
   3-19                    (C)  serious dysfunction of any bodily organ or
   3-20  part; or
   3-21              (2)  to a pregnant woman who is having contractions,
   3-22  and:
   3-23                    (A)  there is inadequate time to effect a safe
   3-24  transfer to another hospital before delivery; or
   3-25                    (B)  transfer may pose a threat to the health or
    4-1  safety of the woman or the unborn child <immediately to:>
    4-2              <(1)  sustain a person's life;>
    4-3              <(2)  prevent serious permanent disfigurement or loss
    4-4  or impairment of the function of a body part or organ; or>
    4-5              <(3)  provide for the care of a woman in active labor
    4-6  or, if the hospital is not equipped for that service, to provide
    4-7  necessary treatment to allow the woman to travel to a more
    4-8  appropriate facility without undue risk of serious harm>.
    4-9        SECTION 4.  Subdivision (19), Section 773.003, Health and
   4-10  Safety Code, as added by Chapter 853, Acts of the 72nd Legislature,
   4-11  Regular Session, 1991, is amended to read as follows:
   4-12              (19)  "Emergency medical care" means <bona fide>
   4-13  emergency services provided:
   4-14                    (A)  after the recent <sudden> onset of a medical
   4-15  <or traumatic> condition manifesting itself by acute symptoms of
   4-16  sufficient severity, including severe pain, such that the absence
   4-17  of immediate medical attention could reasonably be expected to
   4-18  result in:
   4-19                          (i) <(A)>  placing the <patient's> health
   4-20  of the individual (or, with respect to a pregnant woman, the health
   4-21  of the woman or her unborn child) in serious jeopardy;
   4-22                          (ii) <(B)>  serious impairment to bodily
   4-23  functions; or
   4-24                          (iii) <(C)>  serious dysfunction of any
   4-25  bodily organ or part; or
    5-1                    (B)  to a pregnant woman who is having
    5-2  contractions, and:
    5-3                          (i)  there is inadequate time to effect a
    5-4  safe transfer to another hospital before delivery; or
    5-5                          (ii)  transfer may pose a threat to the
    5-6  health or safety of the woman or the unborn child.
    5-7        SECTION 5.  The importance of this legislation and the
    5-8  crowded condition of the calendars in both houses create an
    5-9  emergency and an imperative public necessity that the
   5-10  constitutional rule requiring bills to be read on three several
   5-11  days in each house be suspended, and this rule is hereby suspended.