1-1  By:  Armbrister                                       S.B. No. 1618
    1-2        (In the Senate - Filed March 23, 1995; March 27, 1995, read
    1-3  first time and referred to Committee on Economic Development;
    1-4  April 28, 1995, reported adversely, with favorable Committee
    1-5  Substitute by the following vote:  Yeas 8, Nays 0; April 28, 1995,
    1-6  sent to printer.)
    1-7  COMMITTEE SUBSTITUTE FOR S.B. No. 1618                 By:  Shapiro
    1-8                         A BILL TO BE ENTITLED
    1-9                                AN ACT
   1-10  relating to the certification of providers by health maintenance
   1-11  organizations.
   1-12        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
   1-13        SECTION 1.  Subsection (a), Section 6, Texas Health
   1-14  Maintenance Organization Act (Article 20A.06, Vernon's Texas
   1-15  Insurance Code), is amended to read as follows:
   1-16        (a)  The powers of a health maintenance organization include,
   1-17  but are not limited to, the following:
   1-18              (1)  the purchase, lease, construction, renovation,
   1-19  operation, or maintenance of hospitals, medical facilities, or
   1-20  both, and ancillary equipment and such property as may reasonably
   1-21  be required for its principal office or for such other purposes as
   1-22  may be necessary in the transaction of the business of the health
   1-23  maintenance organization;
   1-24              (2)  the making of loans to a medical group, under an
   1-25  independent contract with it in furtherance of its program, or
   1-26  corporations under its control, for the purpose of acquiring or
   1-27  constructing medical facilities and hospitals, or in the
   1-28  furtherance of a program providing health care services to
   1-29  enrollees;
   1-30              (3)  the furnishing of or arranging for medical care
   1-31  services only through physicians or groups of physicians who have
   1-32  independent contracts with the health maintenance organizations;
   1-33  the furnishing of or arranging for the delivery of health care
   1-34  services only through providers or groups of providers who are
   1-35  under contract with or employed by the health maintenance
   1-36  organization or through physicians or providers who have contracted
   1-37  for health care services with those physicians or providers, except
   1-38  for the furnishing of or authorization for emergency services,
   1-39  services by referral, and services to be provided outside of the
   1-40  service area as approved by the commissioner; provided, however,
   1-41  that a health maintenance organization is not authorized to employ
   1-42  or contract with physicians or providers in any manner which is
   1-43  prohibited by any licensing law of this state under which such
   1-44  physicians or providers are licensed; however, if a hospital,
   1-45  facility, agency, or supplier is certified by the Medicare program
   1-46  under Title XVIII, Social Security Act, as amended (42 U.S.C.
   1-47  Section 1395 et seq.), or accredited by the Joint Commission on
   1-48  Accreditation of Healthcare Organizations or another national
   1-49  accrediting body, the health maintenance organization shall be
   1-50  required to accept such certification or accreditation;
   1-51              (4)  the contracting with any person for the
   1-52  performance on its behalf of certain functions such as marketing,
   1-53  enrollment, and administration;
   1-54              (5)  the contracting with an insurance company licensed
   1-55  in this state, or with a group hospital service corporation
   1-56  authorized to do business in the state, for the provision of
   1-57  insurance, reinsurance, indemnity, or reimbursement against the
   1-58  cost of health care and medical care services provided by the
   1-59  health maintenance organization;
   1-60              (6)  the offering of:
   1-61                    (A)  indemnity benefits covering out-of-area
   1-62  emergency services; and
   1-63                    (B)  indemnity benefits in addition to those
   1-64  relating to out-of-area and emergency services, provided through
   1-65  insurers or group hospital service corporations;
   1-66              (7)  receiving and accepting from government or private
   1-67  agencies payments covering all or part of the cost of the services
   1-68  provided or arranged for by the organization;
    2-1              (8)  all powers given to corporations (including
    2-2  professional corporations and associations), partnerships, and
    2-3  associations pursuant to their organizational documents which are
    2-4  not in conflict with provisions of this Act, or other applicable
    2-5  law.
    2-6        SECTION 2.  Subsection (g), Section 14, Texas Health
    2-7  Maintenance Organization Act (Article 20A.14, Vernon's Texas
    2-8  Insurance Code), is amended to read as follows:
    2-9        (g)  No type of provider licensed or otherwise authorized to
   2-10  practice in this state may be denied participation to provide
   2-11  health care services which are delivered by the health maintenance
   2-12  organization and which are within the scope of licensure or
   2-13  authorization of the type of provider on the sole basis of type of
   2-14  license or authorization.  However, if a hospital, facility,
   2-15  agency, or supplier is certified by the Medicare program under
   2-16  Title XVIII, Social Security Act, as amended (42 U.S.C. Section
   2-17  1395 et seq.), or accredited by the Joint Commission on
   2-18  Accreditation of Healthcare Organizations or another national
   2-19  accrediting body, the health maintenance organization shall be
   2-20  required to accept such certification or accreditation.  This
   2-21  section may not be construed to (1) require a health maintenance
   2-22  organization to utilize a particular type of provider in its
   2-23  operation; (2) require that a health maintenance organization
   2-24  accept each provider of a category or type; or (3) require that
   2-25  health maintenance organizations contract directly with such
   2-26  providers.  Notwithstanding any other provision nothing herein
   2-27  shall be construed to limit the health maintenance organization's
   2-28  authority to set the terms and conditions under which health care
   2-29  services will be rendered by providers.  All providers must comply
   2-30  with the terms and conditions established by the health maintenance
   2-31  organization for the provision of health services and for
   2-32  designation as a provider.
   2-33        SECTION 3.  Section 32.027, Human Resources Code, is amended
   2-34  by adding Subsection (i) to read as follows:
   2-35        (i)  In its establishment of provider criteria for hospitals,
   2-36  home health providers, or hospice providers, the department shall
   2-37  accept licensure by the Texas Department of Health or certification
   2-38  by the Medicare program under Title XVIII, Social Security Act, as
   2-39  amended (42 U.S.C. Section 1395 et seq.).
   2-40        SECTION 4.  Subsection (g), Section 501.059, Government Code,
   2-41  as added by Chapter 238, Acts of the 73rd Legislature, 1993, is
   2-42  amended to read as follows:
   2-43        (g)  The committee shall develop a managed health care plan
   2-44  for all inmates at the institutional division that includes:
   2-45              (1)  the establishment of a managed care network of
   2-46  physicians and hospitals that will serve the institutional division
   2-47  as the exclusive health care provider for inmates at each facility
   2-48  of the institutional division;
   2-49              (2)  cost containment studies; <and>
   2-50              (3)  care case management and utilization management
   2-51  studies performed exclusively for the institutional division; and
   2-52              (4)  as to the establishment of criteria for hospitals,
   2-53  home health providers, or hospice providers, acceptance of
   2-54  licensure by the Texas Department of Health or certification by the
   2-55  Medicare program under Title XVIII, Social Security Act, as amended
   2-56  (42 U.S.C. Section 1395 et seq.).
   2-57        SECTION 5.  The importance of this legislation and the
   2-58  crowded condition of the calendars in both houses create an
   2-59  emergency and an imperative public necessity that the
   2-60  constitutional rule requiring bills to be read on three several
   2-61  days in each house be suspended, and this rule is hereby suspended,
   2-62  and that this Act take effect and be in force from and after its
   2-63  passage, and it is so enacted.
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