Amend CSSB 385 by adding the following SECTION, appropriately
numbered, to the bill and renumbering subsequent SECTIONS  of the
bill appropriately:
      SECTION ____.  (a)  The Texas Health Maintenance Organization
Act (Chapter 20A, Vernon's Texas Insurance Code) is amended by
adding Section 11C to read as follows:
      Sec. 11C.  ENROLLEE INFORMATION RELATING
HYSTERECTOMIES.  (a)  A physician providing services to an enrollee
under a health care plan, before performing a hysterectomy on the
enrollee, shall provide to the enrollee the materials described by
this section. This subsection does not apply if the hysterectomy is
performed in a life-threatening situation in which the physician
determines that providing the materials is not reasonably possible.
If providing the materials is not reasonably possible, the
physician shall include in the enrollee's medical records a written
statement signed by the physician certifying the nature of the
emergency.
      (b)  The commissioner of insurance shall develop and prepare
written materials to inform an enrollee of the risks and hazards of
a hysterectomy and the availability of alternatives to a
hysterectomy. In preparing the information to be provided under
this section, the commissioner may consult with the Texas Medical
Disclosure Panel established under the Medical Liability Insurance
Improvement Act of Texas (Article 4590i, Vernon's Texas Civil
Statutes) or any other appropriate agency of this state.
      (c)  The materials shall be available in English, Spanish,
and any other language the commissioner considers appropriate. The
information must be presented in a manner understandable to a
layperson.
      (d)  The materials must include;
            (1)  a notice that a decision made at any time to
refuse to undergo a hysterectomy will not result in the withdrawal
or withholding of any benefits provided under the health care plan
or under programs or projects receiving federal funds or otherwise
affect the patient's right to future care or treatment;
            (2)  the name of the person providing and explaining
the materials:
            (3)  a statement that the enrollee understands that the
hysterectomy is permanent and nonreversible and that the enrollee
will not be able to become pregnant or bear children if she
undergoes a hysterectomy;
            (4)  a statement that the enrollee has the right to
seek a consultation from a second physician participating in the
health care plan;
            (5)  a statement that the enrollee has been informed
that a hysterectomy is a removal of the uterus through an incision
in the lower abdomen or vagina and that additional surgery may be
necessary to remove or repair other organs, including an ovary,
tube, appendix, bladder, rectum, or vagina;
            (6)  blank spaces to list the procedures to be
performed;
            (7)  a statement that the enrollee was informed of
available and medically appropriate alternatives and blank spaces
to list the alternatives;
            (8)  a description of the discomforts and risks that
may accompany or follow the performance of the procedure;
            (9)  a description of the risks, hazards, and potential
side effects of any anesthetic to be used;
            (10)  a blank space to indicate the approximate length
of hospital stay and time of recovery;
            (11)  a statement of any related cost of the procedure
that the enrollee will be required to pay; and
            (12)  a written statement to be signed by the enrollee
indicating that the materials have been provided and explained to
the enrollee and that the enrollee understands the nature and
consequences of a hysterectomy.
      (b)  The commissioner of insurance shall prescribe the form
and content of the materials required to be distributed under
Section 11C, Texas Health Maintenance Organization Act (Section
20A.11C, Vernon's Texas Insurance Code), as added by this Act, not
later than January 1, 1998.
      (c)  The change in law made by this section applies only to a
hysterectomy performed on or after January 1, 1998, by a physician
providing services to an enrollee under a health care plan.