By Janek, Reyna of Dallas, Christian, Pickett, H.B. No. 812 Galloway 75R2001 DLF-D A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to certain contracts between health maintenance 1-3 organizations and physicians or other providers. 1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-5 SECTION 1. The Texas Health Maintenance Organization Act 1-6 (Chapter 20A, Vernon's Texas Insurance Code) is amended by adding 1-7 Section 18A to read as follows: 1-8 Sec. 18A. PHYSICIAN AND PROVIDER COMMUNICATION. (a) A 1-9 health maintenance organization may not, by contract or otherwise, 1-10 restrict a physician's or provider's ability to communicate with an 1-11 enrollee with respect to: 1-12 (1) the enrollee's coverage under the health care 1-13 plan; 1-14 (2) any subject related to the medical care or health 1-15 care services to be provided to the enrollee, including treatment 1-16 options that are not provided under the health care plan; 1-17 (3) the availability or desirability of another health 1-18 care plan or insurance or similar coverage; or 1-19 (4) the fact that the physician's or provider's 1-20 contract with the health care plan has terminated or that the 1-21 physician or provider will otherwise no longer be providing medical 1-22 care or health care services under the health care plan. 1-23 (b) A contract provision that violates this section is void. 1-24 SECTION 2. This Act takes effect September 1, 1997, and 2-1 applies only to a contract entered into or renewed on or after that 2-2 date. A contract entered into or renewed before September 1, 1997, 2-3 is governed by the law as it existed immediately before that date, 2-4 and that law is continued in effect for that purpose. 2-5 SECTION 3. The importance of this legislation and the 2-6 crowded condition of the calendars in both houses create an 2-7 emergency and an imperative public necessity that the 2-8 constitutional rule requiring bills to be read on three several 2-9 days in each house be suspended, and this rule is hereby suspended. 2-10 COMMITTEE AMENDMENT NO. 1 2-11 Amend H.B. No. 812 as follows: 2-12 On page 1, strike line 17 and 18 completely and renumber text 2-13 accordingly. 2-14 Smithee 2-15 COMMITTEE AMENDMENT NO. 2 2-16 Amend H.B. No. 812 as follows: 2-17 (1) On page 1, line 8, strike "PHYSICIAN AND PROVIDER" and 2-18 substitute "PHYSICIAN, DENTIST, OR PROVIDER". 2-19 (2) On page 1, line 10, strike "physician's or provider's" 2-20 and substitute "physician's, dentist's, or provider's". 2-21 (3) On page 1, line 14, after "medical care", insert ", 2-22 dental care,". 2-23 (4) On page 1, line 19, strike "physician's or provider's" 2-24 and substitute "physician's, dentist's, or provider's". 2-25 (5) On page 1, strike lines 21-22 and substitute "physician, 2-26 dentist, or provider will otherwise no longer be providing medical 2-27 care, dental care, or health care services under the health care 3-1 plan.". 3-2 75R6646 DLF-D Smithee