By Janek, Reyna of Dallas, Christian, H.B. No. 812
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to certain communications between physicians, dentists, or
1-3 other providers and patients or health care plan enrollees and to
1-4 certain related contracts.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. The Texas Health Maintenance Organization Act
1-7 (Chapter 20A, Vernon's Texas Insurance Code) is amended by adding
1-8 Section 18A to read as follows:
1-9 Sec. 18A. PHYSICIAN, DENTIST, OR PROVIDER COMMUNICATION.
1-10 (a) A health maintenance organization may not, by contract or
1-11 otherwise, restrict a physician's, dentist's, or provider's
1-12 ability to communicate with an enrollee with respect to:
1-13 (1) the enrollee's coverage under the health care
1-14 plan;
1-15 (2) any subject related to the medical care, dental
1-16 care, or health care services to be provided to the enrollee,
1-17 including treatment options that are not provided under the health
1-18 care plan; or
1-19 (3) the fact that the physician's, dentist's, or
1-20 provider's contract with the health care plan has terminated or
1-21 that the physician, dentist, or provider will otherwise no longer
1-22 be providing medical care, dental care, or health care services
1-23 under the health care plan.
1-24 (b) A contract provision that violates this section is void.
1-25 SECTION 2. Subchapter E, Chapter 241, Health and Safety
2-1 Code, is amended by adding Section 241.1015 to read as follows:
2-2 Sec. 241.1015. PHYSICIAN COMMUNICATION AND CONTRACTS. (a)
2-3 A hospital, whether by contract, by granting or withholding staff
2-4 privileges, or otherwise, may not restrict a physician's ability to
2-5 communicate with a patient with respect to:
2-6 (1) the patient's coverage under a health care plan;
2-7 (2) any subject related to the medical care or health
2-8 care services to be provided to the patient, including treatment
2-9 options that are not provided under a health care plan;
2-10 (3) the availability or desirability of a health care
2-11 plan or insurance or similar coverage, other than the patient's
2-12 health care plan;
2-13 (4) the availability or desirability of services at
2-14 another hospital; or
2-15 (5) the fact that the physician's staff privileges or
2-16 contract with a hospital or health care plan have terminated or
2-17 that the physician will otherwise no longer be providing medical
2-18 care or health care services at the hospital or under the health
2-19 care plan.
2-20 (b) A hospital, by contract or otherwise, may not refuse or
2-21 fail to grant or renew staff privileges, or condition staff
2-22 privileges, based in whole or in part on the fact that the
2-23 physician or a partner, associate, or employee of the physician is
2-24 providing medical or health care services at a different hospital
2-25 or hospital system.
2-26 (c) A hospital may not contract to limit a physician's
2-27 participation or staff privileges or the participation or staff
3-1 privileges of a partner, associate, or employee of the physician at
3-2 a different hospital or hospital system.
3-3 (d) A contract provision that violates this section is void.
3-4 (e) In this section, "health care plan" has the meaning
3-5 assigned by Section 2, Texas Health Maintenance Organization Act
3-6 (Article 20A.02, Vernon's Texas Insurance Code).
3-7 SECTION 3. This Act takes effect September 1, 1997, and
3-8 applies only to a contract entered into or renewed on or after that
3-9 date. A contract entered into or renewed before September 1, 1997,
3-10 is governed by the law as it existed immediately before that date,
3-11 and that law is continued in effect for that purpose.
3-12 SECTION 4. The importance of this legislation and the
3-13 crowded condition of the calendars in both houses create an
3-14 emergency and an imperative public necessity that the
3-15 constitutional rule requiring bills to be read on three several
3-16 days in each house be suspended, and this rule is hereby suspended.