SRC-JRN C.S.S.B. 976 75(R)BILL ANALYSIS


Senate Research CenterS.B. 976
By: Madla
Economic Development
4-11-97
Committee Report (Substituted)


DIGEST 

Currently, managed care organizations which issue managed care plans under
Medicare risk-sharing contracts are not regulated under the Insurance
Code.  Medicare beneficiaries and providers may be confused regarding
these plans, because Medicare beneficiaries may not be aware of the
consequences of switching from traditional Medicare coverage to a Medicare
risk plan.  This bill requires managed care organizations to provide
notice to providers and a sticker to attach to the enrollee's Medicare
I.D. card that indicates enrollment.  Additionally, this bill requires the
Department of Insurance to provide an ombudsman to assist Medicare
recipients enrolled in managed care plans. 

PURPOSE

As proposed, C.S.S.B. 976 requires managed care organizations to provide
disclosures to prospective enrollees; requires the Department of Insurance
to provide an ombudsman to assist Medicare recipients enrolled in managed
care plans, and ensure that managed care organizations are in compliance
with the law. 

RULEMAKING AUTHORITY

Rulemaking authority is granted to the commissioner of insurance in
SECTION 1 (Section 9, Article 21.52G, Insurance Code) of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Chapter 21E, Insurance Code, by adding Article 21.52G,
as follows: 

Art. 21.52G. REQUIREMENTS FOR MANAGED CARE ORGANIZATIONS UNDER MEDICARE
RISK-SHARING CONTRACTS 

Sec. 1.  DEFINITIONS.  Defines "managed care organization," "managed care
plan," "enrollee," "participating provider," "Medicare," and "risk-sharing
contract." 

Sec. 2.  SCOPE OF ARTICLE.  Provides that this article applies only to
enrollment of a Medicare recipient in a managed care plan issued by a
managed care organization that enters into a risk-sharing contract to
provide certain health care services to Medicare recipients through that
managed care plan. 

Sec. 3. NOTICE TO PROVIDERS.  Requires an organization to provide to each
health care provider listed by the enrollee under Section 3(a) of this
article written notice of the enrollment and notice of the extent to which
the plan will reimburse the provider for services provided to the new
enrollees, by the 10th day after the date on which a managed care
organization enrolls an enrollee in a managed care plan. 

Sec. 4.  DUTIES TO ENROLLEES.  Requires a managed care organization to
provide to an enrollee a sticker to attach to the enrollee's Medicare
identification card that indicates enrollment in the managed care plan.
Requires the sticker to include the name of the plan and the plan's
telephone number.  Requires a managed care organization to ensure
continuity of care for all plan enrollees by ensuring the enrollee's
timely selection of a primary health  care provider who is a participating
provider.  Requires a managed care organization that fails to provide for
the timely selection of a primary health care provider by an enrollee to
reimburse a health care provider for all health care services provided to
the enrollee before the enrollee selects a primary health care provider,
regardless of whether the provider who provides those services is a
participating provider. 

Sec. 5.  OMBUDSMAN.  Requires the Department of Insurance to provide an
ombudsman to assist Medicare recipients enrolled in managed care plans and
to ensure that managed care organizations subject to this article comply
with this article. 

Sec. 6.  MANAGED CARE PLAN FORMS.  Prohibits a managed care organization
from using a printed form for enrollment in a managed care plan unless the
organization files a copy of the form with the commissioner by the 60th
day before the date on which the organization proposes to use the form.
Authorizes the organization to use the form unless the commissioner
notifies the organization of the commissioner's disapproval of the form by
the 15th day before the date of proposed use of the form. 

Sec. 7.  ADVERTISING.  Prohibits a managed care organization from
advertising the availability of its managed care plan for Medicare
recipients unless the organization files a copy of the advertisement with
the commissioner by the 60th day before the date the organization proposes
to use the advertisement.  Provides that the organization may use the
advertisement unless the commissioner notifies the organization of the
commissioner's disapproval of the advertisement by the 15th day before the
date of proposed use of the advertisement. 

Sec. 8.  ADMINISTRATIVE PENALTY.  Provides that a managed care
organization that violates this  article is subject to administrative
penalties under Article 1.10E of this code. 

Sec. 9. RULES.  Requires the commissioner to adopt rules to implement this
article. 

SECTION 2. Requires the commissioner to adopt rules as required by Section
9, Article 21.52G. Insurance Code, by January 1, 1998. 

SECTION 3. (a) Effective date:  September 1, 1997.

(b) and (c) Makes application of this Act prospective to January 1, 1998.

SECTION 4. Emergency clause.  

SUMMARY OF COMMITTEE CHANGES

Amendment 1. 

Page 2, line 8, deletes Section 3, regarding pre-enrollment requirements.
Redesignates existing sections.