By Jones of Dallas H.B. No. 1003 75R4592 PB-F A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to the provision by health maintenance organizations and 1-3 certain other managed care entities of health care services for a 1-4 compensable injury; providing an administrative penalty. 1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-6 SECTION 1. Subchapter B, Chapter 408, Labor Code, is amended 1-7 by adding Section 408.029 to read as follows: 1-8 Sec. 408.029. HEALTH CARE PROVIDED THROUGH MANAGED CARE 1-9 ENTITY. (a) An employee who sustains a compensable injury and who 1-10 receives health care for that injury through a health maintenance 1-11 organization or another managed care entity in which a doctor is 1-12 compensated on a capitated basis is entitled to receive the care 1-13 from a physician or other approved doctor. If the health 1-14 maintenance organization or other managed care entity provides the 1-15 health care through the services of a physician assistant, 1-16 registered nurse, licensed vocational nurse, or other health care 1-17 practitioner who is not a doctor, the health maintenance 1-18 organization or entity must notify the injured employee in writing 1-19 that the employee is entitled to have health care provided by a 1-20 doctor. If the employee elects to have health care provided by a 1-21 doctor, the health maintenance organization or entity may not 1-22 release the employee from treatment for the compensable injury 1-23 until the employee has been examined by a doctor. 1-24 (b) A health maintenance organization or other managed care 2-1 entity that violates Subsection (a) commits a Class A 2-2 administrative violation punishable as provided by Chapter 415. 2-3 (c) In this section, "health maintenance organization" has 2-4 the meaning assigned by the Texas Health Maintenance Organization 2-5 Act (Chapter 20A, Vernon's Texas Insurance Code). 2-6 SECTION 2. This Act takes effect September 1, 1997, and 2-7 applies only to the treatment of an injury that is compensable for 2-8 the purpose of workers' compensation benefits and that occurs on or 2-9 after that date. Treatment for a compensable injury that occurs 2-10 before that date is governed by the law in effect on the date the 2-11 compensable injury occurred, and the former law is continued in 2-12 effect for that purpose. 2-13 SECTION 3. The importance of this legislation and the 2-14 crowded condition of the calendars in both houses create an 2-15 emergency and an imperative public necessity that the 2-16 constitutional rule requiring bills to be read on three several 2-17 days in each house be suspended, and this rule is hereby suspended.