1-1 By: Shapiro S.B. No. 1361
1-2 (In the Senate - Filed March 13, 1995; March 20, 1995, read
1-3 first time and referred to Committee on Economic Development;
1-4 April 26, 1995, reported favorably by the following vote: Yeas 9,
1-5 Nays 0; April 26, 1995, sent to printer.)
1-6 A BILL TO BE ENTITLED
1-7 AN ACT
1-8 relating to the definition of the terms "emergency medical care,"
1-9 "emergency care," and "emergency services."
1-10 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-11 SECTION 1. Subsection (I), Section 2, Chapter 397, Acts of
1-12 the 54th Legislature, 1955 (Article 3.70-2, Vernon's Texas
1-13 Insurance Code), is amended to read as follows:
1-14 (I) An individual or group policy of accident and sickness
1-15 insurance that provides any emergency care benefit, including
1-16 policies issued by companies subject to Chapter 20, Insurance Code,
1-17 delivered or issued for delivery in this state must define
1-18 emergency care as follows: "Emergency care" means <bona fide>
1-19 emergency services provided:
1-20 (1) after the recent <sudden> onset of a medical
1-21 condition manifesting itself by acute symptoms of sufficient
1-22 severity, including severe pain, such that the absence of immediate
1-23 medical attention could reasonably be expected by a prudent
1-24 layperson to result in:
1-25 (a) <(1)> placing the <patient's> health of the
1-26 individual (or, with respect to a pregnant woman, the health of the
1-27 woman or her unborn child) in serious jeopardy;
1-28 (b) <(2)> serious impairment to bodily
1-29 functions; or
1-30 (c) <(3)> serious dysfunction of any bodily
1-31 organ or part; or
1-32 (2) to a pregnant woman who is having contractions,
1-33 and:
1-34 (a) there is inadequate time to effect a safe
1-35 transfer to another hospital before delivery; or
1-36 (b) transfer may pose a threat to the health or
1-37 safety of the woman or the unborn child.
1-38 SECTION 2. Subsection (t), Section 2, Texas Health
1-39 Maintenance Organization Act (Article 20A.02, Vernon's Texas
1-40 Insurance Code), is amended to read as follows:
1-41 (t) "Emergency care" means <bona fide> emergency services
1-42 provided:
1-43 (1) after the recent <sudden> onset of a medical
1-44 condition manifesting itself by acute symptoms of sufficient
1-45 severity, including severe pain, such that the absence of immediate
1-46 medical attention could reasonably be expected by a prudent
1-47 layperson to result in:
1-48 (A) <(1)> placing the <patient's> health of the
1-49 individual (or, with respect to a pregnant woman, the health of the
1-50 woman or her unborn child) in serious jeopardy;
1-51 (B) <(2)> serious impairment to bodily
1-52 functions; or
1-53 (C) <(3)> serious dysfunction of any bodily
1-54 organ or part; or
1-55 (2) to a pregnant woman who is having contractions,
1-56 and:
1-57 (A) there is inadequate time to effect a safe
1-58 transfer to another hospital before delivery; or
1-59 (B) transfer may pose a threat to the health or
1-60 safety of the woman or the unborn child.
1-61 SECTION 3. Section 311.021, Health and Safety Code, is
1-62 amended to read as follows:
1-63 Sec. 311.021. DEFINITION. In this subchapter, "emergency
1-64 services" means services that are usually and customarily available
1-65 at a hospital and that must be provided:
1-66 (1) after the recent onset of a medical condition
1-67 manifesting itself by acute symptoms of sufficient severity,
1-68 including severe pain, such that the absence of immediate medical
2-1 attention could reasonably be expected to result in:
2-2 (A) placing the health of the individual (or,
2-3 with respect to a pregnant woman, the health of the woman or her
2-4 unborn child) in serious jeopardy;
2-5 (B) serious impairment to bodily functions; or
2-6 (C) serious dysfunction of any bodily organ or
2-7 part; or
2-8 (2) to a pregnant woman who is having contractions,
2-9 and:
2-10 (A) there is inadequate time to effect a safe
2-11 transfer to another hospital before delivery; or
2-12 (B) transfer may pose a threat to the health or
2-13 safety of the woman or the unborn child <immediately to:>
2-14 <(1) sustain a person's life;>
2-15 <(2) prevent serious permanent disfigurement or loss
2-16 or impairment of the function of a body part or organ; or>
2-17 <(3) provide for the care of a woman in active labor
2-18 or, if the hospital is not equipped for that service, to provide
2-19 necessary treatment to allow the woman to travel to a more
2-20 appropriate facility without undue risk of serious harm>.
2-21 SECTION 4. Subdivision (19), Section 773.003, Health and
2-22 Safety Code, as added by Chapter 853, Acts of the 72nd Legislature,
2-23 Regular Session, 1991, is amended to read as follows:
2-24 (19) "Emergency medical care" means <bona fide>
2-25 emergency services provided:
2-26 (A) after the recent <sudden> onset of a medical
2-27 <or traumatic> condition manifesting itself by acute symptoms of
2-28 sufficient severity, including severe pain, such that the absence
2-29 of immediate medical attention could reasonably be expected to
2-30 result in:
2-31 (i) <(A)> placing the <patient's> health
2-32 of the individual (or, with respect to a pregnant woman, the health
2-33 of the woman or her unborn child) in serious jeopardy;
2-34 (ii) <(B)> serious impairment to bodily
2-35 functions; or
2-36 (iii) <(C)> serious dysfunction of any
2-37 bodily organ or part; or
2-38 (B) to a pregnant woman who is having
2-39 contractions, and:
2-40 (i) there is inadequate time to effect a
2-41 safe transfer to another hospital before delivery; or
2-42 (ii) transfer may pose a threat to the
2-43 health or safety of the woman or the unborn child.
2-44 SECTION 5. The importance of this legislation and the
2-45 crowded condition of the calendars in both houses create an
2-46 emergency and an imperative public necessity that the
2-47 constitutional rule requiring bills to be read on three several
2-48 days in each house be suspended, and this rule is hereby suspended.
2-49 * * * * *