By Nelson S.B. No. 39 75R1675 PB-D A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to access to certain obstetric or gynecological health 1-3 care under a health benefits 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 21.53D to read as follows: 1-7 Art. 21.53D. ACCESS TO CERTAIN OBSTETRIC OR GYNECOLOGICAL 1-8 CARE. (a) In this article, "health benefits plan" means an 1-9 individual or group insurance policy, hospital service contract, or 1-10 contract issued by a health maintenance organization that: 1-11 (1) is delivered, issued for delivery, or renewed in 1-12 this state; 1-13 (2) provides benefits for medical or surgical expenses 1-14 incurred as a result of accident, sickness, or another health 1-15 condition; and 1-16 (3) provides benefits for certain specialty health 1-17 care services only through a referral made by a primary care 1-18 physician or other gatekeeper. 1-19 (b) In addition to other benefits as authorized by the plan, 1-20 each health benefits plan shall permit a woman who is entitled to 1-21 coverage under the plan direct access as provided by Subsection (c) 1-22 of this article to the health care services of a participating 1-23 obstetrician-gynecologist who is: 1-24 (1) authorized to provide services under the plan; and 2-1 (2) selected by the covered individual. 2-2 (c) The access to health care services required under this 2-3 article includes an annual gynecological physical examination and 2-4 additional self-referred office visits as necessary for women's 2-5 health services. 2-6 (d) Each health benefits plan shall provide appropriate 2-7 written notice to persons covered by the plan of the direct access 2-8 to health care services required by this article. 2-9 SECTION 2. Article 21.53D, Insurance Code, as added by 2-10 Section 1 of this Act, applies only to an insurance policy, 2-11 contract, or evidence of coverage delivered, issued for delivery, 2-12 or renewed on or after January 1, 1998. A policy, contract, or 2-13 evidence of coverage delivered, issued for delivery, or renewed 2-14 before January 1, 1998, is governed by the law as it existed 2-15 immediately before the effective date of this Act, and that law is 2-16 continued in effect for that purpose. 2-17 SECTION 3. This Act takes effect September 1, 1997. 2-18 SECTION 4. The importance of this legislation and the 2-19 crowded condition of the calendars in both houses create an 2-20 emergency and an imperative public necessity that the 2-21 constitutional rule requiring bills to be read on three several 2-22 days in each house be suspended, and this rule is hereby suspended.