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. 2-22 * * * * *