1-1     By:  Janek, et al. (Senate Sponsor - Sibley)           H.B. No. 812

 1-2           (In the Senate - Received from the House May 7, 1997;

 1-3     May 8, 1997, read first time and referred to Committee on Economic

 1-4     Development; May 16, 1997, reported adversely, with favorable

 1-5     Committee Substitute by the following vote:  Yeas 8, Nays 0;

 1-6     May 16, 1997, sent to printer.)

 1-7     COMMITTEE SUBSTITUTE FOR H.B. No. 812                   By:  Sibley

 1-8                            A BILL TO BE ENTITLED

 1-9                                   AN ACT

1-10     relating to certain communications between physicians, dentists, or

1-11     other providers and patients or health care plan enrollees and to

1-12     certain related contracts.

1-13           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

1-14           SECTION 1.  The Texas Health Maintenance Organization Act

1-15     (Chapter 20A, Vernon's Texas Insurance Code), is amended by adding

1-16     Section 18A to read as follows:

1-17           Sec. 18A.  PHYSICIAN, DENTIST, OR PROVIDER COMMUNICATION.

1-18           (a)  A health maintenance organization may not, as a

1-19     condition of a contract with a physician, dentist, or provider, or

1-20     in any other manner, prohibit, attempt to prohibit, or discourage a

1-21     physician, dentist, or provider from discussing with or

1-22     communicating in good faith to a current, prospective, or former

1-23     patient, or a party designated by a patient, with respect to:

1-24                 (1)  information or opinions regarding the patient's

1-25     health care, including the patient's medical condition or treatment

1-26     options;

1-27                 (2)  information or opinions regarding the provisions,

1-28     terms, requirements, or services of the health care plan as they

1-29     relate to the medical needs of the patient; or

1-30                 (3)  the fact that the physician's, dentist's, or

1-31     provider's contract with the health care plan has terminated or

1-32     that the physician, dentist, or provider will otherwise no longer

1-33     be providing medical care, dental care, or health care services

1-34     under the health care plan.

1-35           (b)  A health maintenance organization may not in any way

1-36     penalize, terminate, or refuse to compensate, for covered services,

1-37     a physician, dentist, or provider for communicating with a current,

1-38     prospective, or former patient, or a party designated by a patient,

1-39     in any manner protected by this section.

1-40           (c)  A contract provision that violates this section is

1-41     hereby declared void.

1-42           SECTION 2.  Subchapter E, Chapter 241, Health and Safety

1-43     Code, is amended by adding Section 241.1015 to read as follows:

1-44           Sec. 241.1015.  PHYSICIAN COMMUNICATION AND CONTRACTS.

1-45     (a)  A hospital, whether by contract, by granting or withholding

1-46     staff privileges, or otherwise, may not restrict a physician's

1-47     ability to communicate with a patient with respect to:

1-48                 (1)  the patient's coverage under a health care plan;

1-49                 (2)  any subject related to the medical care or health

1-50     care services to be provided to the patient, including treatment

1-51     options that are not provided under a health care plan;

1-52                 (3)  the availability or desirability of a health care

1-53     plan or insurance or similar coverage, other than the patient's

1-54     health care plan;

1-55                 (4)  the availability or desirability of services at

1-56     another hospital; or

1-57                 (5)  the fact that the physician's staff privileges or

1-58     contract with a hospital or health care plan have terminated or

1-59     that the physician will otherwise no longer be providing medical

1-60     care or health care services at the hospital or under the health

1-61     care plan.

1-62           (b)  A hospital, by contract or otherwise, may not refuse or

1-63     fail to grant or renew staff privileges, or condition staff

1-64     privileges, based in whole or in part on the fact that the

 2-1     physician or a partner, associate, or employee of the physician is

 2-2     providing medical or health care services at a different hospital

 2-3     or hospital system.

 2-4           (c)  A hospital may not contract to limit a physician's

 2-5     participation or staff privileges or the participation or staff

 2-6     privileges of a partner, associate, or employee of the physician at

 2-7     a different hospital or hospital system.

 2-8           (d)  A contract provision that violates this section is void.

 2-9           (e)  In this section, "health care plan" has the meaning

2-10     assigned by Section 2, Texas Health Maintenance Organization Act

2-11     (Article 20A.02, Vernon's Texas Insurance Code).

2-12           SECTION 3.  This Act takes effect September 1, 1997, and

2-13     applies only to a contract entered into or renewed on or after that

2-14     date.  A contract entered into or renewed before September 1, 1997,

2-15     is governed by the law as it existed immediately before that date,

2-16     and that law is continued in effect for that purpose.

2-17           SECTION 4.  The importance of this legislation and the

2-18     crowded condition of the calendars in both houses create an

2-19     emergency and an imperative public necessity that the

2-20     constitutional rule requiring bills to be read on three several

2-21     days in each house be suspended, and this rule is hereby suspended.

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