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