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.