By Davila                                       H.B. No. 3188

      75R7353 DLF-D                           

                                A BILL TO BE ENTITLED

 1-1                                   AN ACT

 1-2     relating to  the relationship of physicians and health care

 1-3     providers to enrollees in a managed care plan.

 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 Article 21.52K to read as follows:

 1-7           Art. 21.52K.  PHYSICIAN AND PROVIDER COMMUNICATION AND

 1-8     ASSISTANCE TO ENROLLEES

 1-9           Sec. 1.  DEFINITIONS.  In this article:

1-10                 (1)  "Enrollee" means an individual who is enrolled in

1-11     a managed care plan. The term includes a dependent of an enrollee

1-12     who is covered under the plan.

1-13                 (2)  "Managed care entity" means an entity described by

1-14     Section 2 of this article.

1-15                 (3)  "Managed care plan" means a health benefit plan:

1-16                       (A)  under which medical care or health care

1-17     services are provided to enrollees through contracts with

1-18     physicians and health care providers; and

1-19                       (B)  that provides financial incentives to

1-20     enrollees in the plan to use the participating physicians and

1-21     health care providers and procedures covered by the plan.

1-22                 (4)  "Physician" means a person licensed to practice

1-23     medicine in this state.

1-24                 (5)  "Health care provider" means a provider, as that

 2-1     term is defined by Section 2, Texas Health Maintenance Organization

 2-2     Act (Section 20A.02, Vernon's Texas Insurance Code). The term

 2-3     includes a dentist.

 2-4           Sec. 2.  SCOPE OF ARTICLE.  This article applies to a health

 2-5     maintenance organization organized under the Texas Health

 2-6     Maintenance Organization Act (Chapter 20A, Vernon's Texas Insurance

 2-7     Code), a preferred provider organization, an approved nonprofit

 2-8     health corporation that holds a certificate of authority  issued by

 2-9     the commissioner under Article 21.52F of this code, or any other

2-10     entity that offers a managed care plan, including:

2-11                 (1)  an insurance company;

2-12                 (2)  a group hospital service corporation operating

2-13     under Chapter 20 of this code;

2-14                 (3)  a fraternal benefit society operating under

2-15     Chapter 10 of this code;

2-16                 (4)  a stipulated premium insurance company operating

2-17     under Chapter 22 of this code; or

2-18                 (5)  to the extent permitted by the Employee Retirement

2-19     Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.):

2-20                       (A)  a multiple employer welfare arrangement as

2-21     defined by Section 3, Employee Retirement Income Security Act of

2-22     1974 (29 U.S.C. Section 1002), or another analogous benefit

2-23     arrangement; or

2-24                       (B)  any other entity not licensed under this

2-25     code or another insurance law of this state that contracts directly

2-26     for medical care or health care services on a risk-sharing basis,

2-27     including an entity that contracts for medical care or health care

 3-1     services under a capitation method.

 3-2           Sec. 3.  PHYSICIAN AND PROVIDER COMMUNICATION.  A managed

 3-3     care entity may not, by contract or otherwise,  restrict a

 3-4     physician's or health care provider's ability to communicate with

 3-5     an enrollee with respect to:

 3-6                 (1)  the enrollee's coverage under the managed care

 3-7     plan;

 3-8                 (2)  any subject related to the medical care or health

 3-9     care services to be provided to the enrollee, including treatment

3-10     options that are not provided under the managed care plan;

3-11                 (3)  the availability or desirability of another health

3-12     benefit plan or insurance or similar coverage;

3-13                 (4)  the financial arrangement between the physician or

3-14     health care provider and the managed care entity; or

3-15                 (5)  the fact that the physician's or provider's

3-16     contract with the managed care plan has terminated or that the

3-17     physician or provider will otherwise no longer be providing medical

3-18     care or health care services under the health benefit plan.

3-19           Sec. 4.  APPEAL OF DETERMINATION.  A physician or health care

3-20     provider may participate, on behalf of an enrollee, in any appeal

3-21     or review of a determination made by a managed care entity that,

3-22     concurrently or prospectively, denies benefits for a treatment

3-23     recommended or prescribed by the physician or health care provider

3-24     for the enrollee in the course of providing medical care or health

3-25     care to the enrollee under the managed care plan.

3-26           Sec. 5.  RETALIATION PROHIBITED.  A managed care entity may

3-27     not terminate the contract of a physician or health care provider

 4-1     or take any other retaliatory action against the physician or

 4-2     provider because the physician or health care provider has

 4-3     exercised the physician's or provider's rights under this article.

 4-4           Sec. 6.  CONTRACT VOID.  A contract provision that violates

 4-5     this article is void.

 4-6           SECTION 2.  This Act takes effect September 1, 1997, and

 4-7     applies only to a contract between a physician or health care

 4-8     provider and a managed care entity entered into or renewed on or

 4-9     after that date.  A contract between a physician or health care

4-10     provider and a managed care entity entered into or renewed before

4-11     September 1, 1997, is governed by the law as it existed immediately

4-12     before the effective date of this Act, and that law is continued in

4-13     effect for that purpose.

4-14           SECTION 3.  The importance of this legislation and the

4-15     crowded condition of the calendars in both houses create an

4-16     emergency and an imperative public necessity that the

4-17     constitutional rule requiring bills to be read on three several

4-18     days in each house be suspended, and this rule is hereby suspended.