By Davila                                       H.B. No. 3123

      75R7351 DLF-D                           

                                A BILL TO BE ENTITLED

 1-1                                   AN ACT

 1-2     relating to coverage for certain treatments under managed care

 1-3     plans.

 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

 1-5           SECTION 1.  Subchapter E, Chapter 21, Insurance Code, is

 1-6     amended by adding Section 21.52I to read as follows:

 1-7           Art. 21.52I.  BENEFITS FOR EXPERIMENTAL TREATMENTS

 1-8           Sec. 1.  DEFINITIONS.  In this article:

 1-9                 (1)  "Managed care entity" means an entity described by

1-10     Section 2 of this article.

1-11                 (2)  "Managed care plan" means a health benefit plan:

1-12                       (A)  under which health care services are

1-13     provided to enrollees through contracts with health care

1-14     professionals  or health care facilities; and

1-15                       (B)  that provides financial incentives to

1-16     enrollees in the plan to use the participating practitioners,

1-17     participating health care facilities, and procedures covered by the

1-18     plan.

1-19           Sec. 2.  SCOPE OF ARTICLE.  This article applies to a health

1-20     maintenance organization, a preferred provider organization, an

1-21     approved nonprofit health corporation that holds a certificate of

1-22     authority  issued by the commissioner under Article 21.52F of this

1-23     code, and any other entity that offers a managed care plan,

1-24     including:

 2-1                 (1)  an insurance company;

 2-2                 (2)  a group hospital service corporation operating

 2-3     under Chapter 20 of this code;

 2-4                 (3)  a fraternal benefit society operating under

 2-5     Chapter 10 of this code;

 2-6                 (4)  a stipulated premium insurance company operating

 2-7     under Chapter 22 of this code; or

 2-8                 (5)  to the extent permitted by the Employee Retirement

 2-9     Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.):

2-10                       (A)  a multiple employer welfare arrangement as

2-11     defined by Section 3, Employee Retirement Income Security Act of

2-12     1974 (29 U.S.C. Section 1002), or another analogous benefit

2-13     arrangement; or

2-14                       (B)  any other entity not licensed under this

2-15     code or another insurance law of this state that contracts directly

2-16     for health care services on a risk-sharing basis, including an

2-17     entity that contracts for health care services under a capitation

2-18     method.

2-19           Sec. 3.  COVERAGE FOR EXPERIMENTAL TREATMENT.  A managed care

2-20     plan may not exclude benefits for a treatment for a particular

2-21     condition or illness solely because the treatment is experimental

2-22     for that condition or illness if:

2-23                 (1)  benefits for treatment of the illness or condition

2-24     are provided under the managed care plan;

2-25                 (2)  the treatment is recognized for treatment of the

2-26     particular illness or condition; and

2-27                 (3)  there is not a clearly superior commonly used

 3-1     treatment alternative for the illness or condition available to the

 3-2     enrollee.

 3-3           Sec. 4.  NOTICE; REVIEW.  (a)  A managed care entity that

 3-4     denies benefits for a treatment for an enrollee that has been

 3-5     prescribed or recommended by a physician treating the enrollee

 3-6     under the managed care plan on the grounds that the treatment is

 3-7     experimental for the enrollee's illness or condition  shall notify

 3-8     the enrollee in writing of:

 3-9                 (1)  the reason for the denial of benefits; and

3-10                 (2)  the enrollee's right to a review of the

3-11     determination under this section.

3-12           (b)  An enrollee may request a review of the managed care

3-13     entity's denial of benefits.  The review must be conducted by a

3-14     physician in the same area of specialty as the physician who

3-15     prescribed or recommended the treatment for which benefits have

3-16     been denied.  The physician conducting the review shall determine

3-17     whether the treatment is appropriate and medically necessary for

3-18     the enrollee and whether coverage for the treatment is required

3-19     under this article.

3-20           (c)  The commissioner may adopt rules governing the review

3-21     required by this section, including rules governing the time within

3-22     which the review must be completed.

3-23           SECTION 2.  This Act takes effect September 1, 1997, and

3-24     applies only to an insurance policy that is delivered, issued for

3-25     delivery, or renewed on or after January 1, 1998.  A policy that is

3-26     delivered, issued for delivery, or renewed before January 1, 1998,

3-27     is governed by the law as it existed immediately before the

 4-1     effective date of this Act, and that law is continued in effect for

 4-2     that purpose.

 4-3           SECTION 3.  The importance of this legislation and the

 4-4     crowded condition of the calendars in both houses create an

 4-5     emergency and an imperative public necessity that the

 4-6     constitutional rule requiring bills to be read on three several

 4-7     days in each house be suspended, and this rule is hereby suspended.