AN ACT
1-1 relating to review of and liability for certain health care
1-2 treatment decisions.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Title 4, Civil Practice and Remedies Code, is
1-5 amended by adding Chapter 88 to read as follows:
1-6 CHAPTER 88. HEALTH CARE LIABILITY
1-7 Sec. 88.001. DEFINITIONS. In this chapter:
1-8 (1) "Appropriate and medically necessary" means the
1-9 standard for health care services as determined by physicians and
1-10 health care providers in accordance with the prevailing practices
1-11 and standards of the medical profession and community.
1-12 (2) "Enrollee" means an individual who is enrolled in
1-13 a health care plan, including covered dependents.
1-14 (3) "Health care plan" means any plan whereby any
1-15 person undertakes to provide, arrange for, pay for, or reimburse
1-16 any part of the cost of any health care services.
1-17 (4) "Health care provider" means a person or entity as
1-18 defined in Section 1.03(a)(3), Medical Liability and Insurance
1-19 Improvement Act of Texas (Article 4590i, Vernon's Texas Civil
1-20 Statutes).
1-21 (5) "Health care treatment decision" means a
1-22 determination made when medical services are actually provided by
1-23 the health care plan and a decision which affects the quality of
2-1 the diagnosis, care, or treatment provided to the plan's insureds
2-2 or enrollees.
2-3 (6) "Health insurance carrier" means an authorized
2-4 insurance company that issues policies of accident and sickness
2-5 insurance under Section 1, Chapter 397, Acts of the 54th
2-6 Legislature, 1955 (Article 3.70-1, Vernon's Texas Insurance Code).
2-7 (7) "Health maintenance organization" means an
2-8 organization licensed under the Texas Health Maintenance
2-9 Organization Act (Chapter 20A, Vernon's Texas Insurance Code).
2-10 (8) "Managed care entity" means any entity which
2-11 delivers, administers, or assumes risk for health care services
2-12 with systems or techniques to control or influence the quality,
2-13 accessibility, utilization, or costs and prices of such services
2-14 to a defined enrollee population, but does not include an employer
2-15 purchasing coverage or acting on behalf of its employees or the
2-16 employees of one or more subsidiaries or affiliated corporations of
2-17 the employer or a pharmacy licensed by the State Board of Pharmacy.
2-18 (9) "Physician" means:
2-19 (A) an individual licensed to practice medicine
2-20 in this state;
2-21 (B) a professional association organized under
2-22 the Texas Professional Association Act (Article 1528f, Vernon's
2-23 Texas Civil Statutes) or a nonprofit health corporation certified
2-24 under Section 5.01, Medical Practice Act (Article 4495b, Vernon's
2-25 Texas Civil Statutes); or
3-1 (C) another person wholly owned by physicians.
3-2 (10) "Ordinary care" means, in the case of a health
3-3 insurance carrier, health maintenance organization, or managed care
3-4 entity, that degree of care that a health insurance carrier, health
3-5 maintenance organization, or managed care entity of ordinary
3-6 prudence would use under the same or similar circumstances. In the
3-7 case of a person who is an employee, agent, ostensible agent, or
3-8 representative of a health insurance carrier, health maintenance
3-9 organization, or managed care entity, "ordinary care" means that
3-10 degree of care that a person of ordinary prudence in the same
3-11 profession, specialty, or area of practice as such person would use
3-12 in the same or similar circumstances.
3-13 Sec. 88.002. APPLICATION. (a) A health insurance carrier,
3-14 health maintenance organization, or other managed care entity for a
3-15 health care plan has the duty to exercise ordinary care when making
3-16 health care treatment decisions and is liable for damages for harm
3-17 to an insured or enrollee proximately caused by its failure to
3-18 exercise such ordinary care.
3-19 (b) A health insurance carrier, health maintenance
3-20 organization, or other managed care entity for a health care plan
3-21 is also liable for damages for harm to an insured or enrollee
3-22 proximately caused by the health care treatment decisions made by
3-23 its:
3-24 (1) employees;
3-25 (2) agents;
4-1 (3) ostensible agents; or
4-2 (4) representatives who are acting on its behalf and
4-3 over whom it has the right to exercise influence or control or has
4-4 actually exercised influence or control which result in the failure
4-5 to exercise ordinary care.
4-6 (c) It shall be a defense to any action asserted against a
4-7 health insurance carrier, health maintenance organization, or other
4-8 managed care entity for a health care plan that:
4-9 (1) neither the health insurance carrier, health
4-10 maintenance organization, or other managed care entity, nor any
4-11 employee, agent, ostensible agent, or representative for whose
4-12 conduct such health insurance carrier, health maintenance
4-13 organization, or other managed care entity is liable under
4-14 Subsection (b), controlled, influenced, or participated in the
4-15 health care treatment decision; and
4-16 (2) the health insurance carrier, health maintenance
4-17 organization, or other managed care entity did not deny or delay
4-18 payment for any treatment prescribed or recommended by a provider
4-19 to the insured or enrollee.
4-20 (d) The standards in Subsections (a) and (b) create no
4-21 obligation on the part of the health insurance carrier, health
4-22 maintenance organization, or other managed care entity to provide
4-23 to an insured or enrollee treatment which is not covered by the
4-24 health care plan of the entity.
4-25 (e) This chapter does not create any liability on the part
5-1 of an employer, an employer group purchasing organization, or a
5-2 pharmacy licensed by the State Board of Pharmacy that purchases
5-3 coverage or assumes risk on behalf of its employees.
5-4 (f) A health insurance carrier, health maintenance
5-5 organization, or managed care entity may not remove a physician or
5-6 health care provider from its plan or refuse to renew the physician
5-7 or health care provider with its plan for advocating on behalf of
5-8 an enrollee for appropriate and medically necessary health care for
5-9 the enrollee.
5-10 (g) A health insurance carrier, health maintenance
5-11 organization, or other managed care entity may not enter into a
5-12 contract with a physician, hospital, or other health care provider
5-13 or pharmaceutical company which includes an indemnification or hold
5-14 harmless clause for the acts or conduct of the health insurance
5-15 carrier, health maintenance organization, or other managed care
5-16 entity. Any such indemnification or hold harmless clause in an
5-17 existing contract is hereby declared void.
5-18 (h) Nothing in any law of this state prohibiting a health
5-19 insurance carrier, health maintenance organization, or other
5-20 managed care entity from practicing medicine or being licensed to
5-21 practice medicine may be asserted as a defense by such health
5-22 insurance carrier, health maintenance organization, or other
5-23 managed care entity in an action brought against it pursuant to
5-24 this section or any other law.
5-25 (i) In an action against a health insurance carrier, health
6-1 maintenance organization, or managed care entity, a finding that a
6-2 physician or other health care provider is an employee, agent,
6-3 ostensible agent, or representative of such health insurance
6-4 carrier, health maintenance organization, or managed care entity
6-5 shall not be based solely on proof that such person's name appears
6-6 in a listing of approved physicians or health care providers made
6-7 available to insureds or enrollees under a health care plan.
6-8 (j) This chapter does not apply to workers' compensation
6-9 insurance coverage as defined in Section 401.011, Labor Code.
6-10 (k) An enrollee who files an action under this chapter shall
6-11 comply with the requirements of Section 13.01, Medical Liability
6-12 and Insurance Improvement Act of Texas (Article 4590i, Vernon's
6-13 Texas Civil Statutes), as it relates to cost bonds, deposits, and
6-14 expert reports.
6-15 Sec. 88.003. LIMITATIONS ON CAUSE OF ACTION. (a) A person
6-16 may not maintain a cause of action under this chapter against a
6-17 health insurance carrier, health maintenance organization, or other
6-18 managed care entity that is required to comply with the utilization
6-19 review requirements of Article 21.58A, Insurance Code, or the Texas
6-20 Health Maintenance Organization Act (Chapter 20A, Vernon's Texas
6-21 Insurance Code), unless the affected insured or enrollee or the
6-22 insured's or enrollee's representative:
6-23 (1) has exhausted the appeals and review applicable
6-24 under the utilization review requirements; or
6-25 (2) before instituting the action:
7-1 (A) gives written notice of the claim as
7-2 provided by Subsection (b); and
7-3 (B) agrees to submit the claim to a review by an
7-4 independent review organization under Article 21.58A, Insurance
7-5 Code, as required by Subsection (c).
7-6 (b) The notice required by Subsection (a)(2)(A) must be
7-7 delivered or mailed to the health insurance carrier, health
7-8 maintenance organization, or managed care entity against whom the
7-9 action is made not later than the 30th day before the date the
7-10 claim is filed.
7-11 (c) The insured or enrollee or the insured's or enrollee's
7-12 representative must submit the claim to a review by an independent
7-13 review organization if the health insurance carrier, health
7-14 maintenance organization, or managed care entity against whom the
7-15 claim is made requests the review not later than the 14th day after
7-16 the date notice under Subsection (a)(2)(A) is received by the
7-17 health insurance carrier, health maintenance organization, or
7-18 managed care entity. If the health insurance carrier, health
7-19 maintenance organization, or managed care entity does not request
7-20 the review within the period specified by this subsection, the
7-21 insured or enrollee or the insured's or enrollee's representative
7-22 is not required to submit the claim to independent review before
7-23 maintaining the action.
7-24 (d) Subject to Subsection (e), if the enrollee has not
7-25 complied with Subsection (a), an action under this section shall
8-1 not be dismissed by the court, but the court may, in its
8-2 discretion, order the parties to submit to an independent review or
8-3 mediation or other nonbinding alternative dispute resolution and
8-4 may abate the action for a period of not to exceed 30 days for such
8-5 purposes. Such orders of the court shall be the sole remedy
8-6 available to a party complaining of an enrollee's failure to comply
8-7 with Subsection (a).
8-8 (e) The enrollee is not required to comply with Subsection
8-9 (c) and no abatement or other order pursuant to Subsection (d) for
8-10 failure to comply shall be imposed if the enrollee has filed a
8-11 pleading alleging in substance that:
8-12 (1) harm to the enrollee has already occurred because
8-13 of the conduct of the health insurance carrier, health maintenance
8-14 organization, or managed care entity or because of an act or
8-15 omission of an employee, agent, ostensible agent, or representative
8-16 of such carrier, organization, or entity for whose conduct it is
8-17 liable under Section 88.002(b); and
8-18 (2) the review would not be beneficial to the
8-19 enrollee, unless the court, upon motion by a defendant carrier,
8-20 organization, or entity finds after hearing that such pleading was
8-21 not made in good faith, in which case the court may enter an order
8-22 pursuant to Subsection (d).
8-23 (f) If the insured or enrollee or the insured's or
8-24 enrollee's representative seeks to exhaust the appeals and review
8-25 or provides notice, as required by Subsection (a), before the
9-1 statute of limitations applicable to a claim against a managed care
9-2 entity has expired, the limitations period is tolled until the
9-3 later of:
9-4 (1) the 30th day after the date the insured or
9-5 enrollee or the insured's or enrollee's representative has
9-6 exhausted the process for appeals and review applicable under the
9-7 utilization review requirements; or
9-8 (2) the 40th day after the date the insured or
9-9 enrollee or the insured's or enrollee's representative gives notice
9-10 under Subsection (a)(2)(A).
9-11 (g) This section does not prohibit an insured or enrollee
9-12 from pursuing other appropriate remedies, including injunctive
9-13 relief, a declaratory judgment, or relief available under law, if
9-14 the requirement of exhausting the process for appeal and review
9-15 places the insured's or enrollee's health in serious jeopardy.
9-16 SECTION 2. Section 6, Article 21.58A, Insurance Code, is
9-17 amended by amending Subsection (b) and adding Subsection (c) to
9-18 read as follows:
9-19 (b) The procedures for appeals shall be reasonable and shall
9-20 include the following:
9-21 (1) a provision that an enrollee, a person acting on
9-22 behalf of the enrollee, or the enrollee's physician or health care
9-23 provider may appeal the adverse determination and shall be
9-24 provided, on request, a clear and concise statement of the clinical
9-25 basis for the adverse determination;
10-1 (2) a list of documents needed to be submitted by the
10-2 appealing party to the utilization review agent for the appeal;
10-3 (3) a provision that appeal decisions shall be made by
10-4 a physician, provided that, if the appeal is denied and within 10
10-5 working days the health care provider sets forth in writing good
10-6 cause for having a particular type of a specialty provider review
10-7 the case, the denial shall be reviewed by a health care provider in
10-8 the same or similar specialty as typically manages the medical
10-9 condition, procedure, or treatment under discussion for review of
10-10 the adverse determination;
10-11 (4) in addition to the written appeal, a method for an
10-12 expedited appeal procedure for emergency care denials and denials
10-13 of continued stays for hospitalized patients, which shall include a
10-14 health care provider who has not previously reviewed the case; such
10-15 appeal must be completed no later than one working day following
10-16 the day on which the appeal, including all information necessary to
10-17 complete the appeal, is made to the utilization review agent; and
10-18 (5) written notification to the appealing party of the
10-19 determination of the appeal, as soon as practical, but in no case
10-20 later than the 30th day after the date the utilization agent
10-21 receives [30 days after receiving all the required documentation
10-22 of] the appeal. If the appeal is denied, the written notification
10-23 shall include a clear and concise statement of:
10-24 (A) the clinical basis for the appeal's denial;
10-25 (B) [and] the specialty of the physician making
11-1 the denial; and
11-2 (C) notice of the appealing party's right to
11-3 seek review of the denial by an independent review organization
11-4 under Section 6A of this article and the procedures for obtaining
11-5 that review.
11-6 (c) Notwithstanding any other law, in a circumstance
11-7 involving an enrollee's life-threatening condition, the enrollee is
11-8 entitled to an immediate appeal to an independent review
11-9 organization as provided by Section 6A of this article and is not
11-10 required to comply with procedures for an internal review of the
11-11 utilization review agent's adverse determination. For purposes of
11-12 this section, "life-threatening condition" means a disease or other
11-13 medical condition with respect to which death is probable unless
11-14 the course of the disease or condition is interrupted.
11-15 SECTION 3. Article 21.58A, Insurance Code, is amended by
11-16 adding Section 6A to read as follows:
11-17 Sec. 6A. INDEPENDENT REVIEW OF ADVERSE DETERMINATIONS. A
11-18 utilization review agent shall:
11-19 (1) permit any party whose appeal of an adverse
11-20 determination is denied by the utilization review agent to seek
11-21 review of that determination by an independent review organization
11-22 assigned to the appeal in accordance with Article 21.58C of this
11-23 code;
11-24 (2) provide to the appropriate independent review
11-25 organization not later than the third business day after the date
12-1 that the utilization review agent receives a request for review a
12-2 copy of:
12-3 (A) any medical records of the enrollee that are
12-4 relevant to the review;
12-5 (B) any documents used by the plan in making the
12-6 determination to be reviewed by the organization;
12-7 (C) the written notification described by
12-8 Section 6(b)(5) of this article;
12-9 (D) any documentation and written information
12-10 submitted to the utilization review agent in support of the appeal;
12-11 and
12-12 (E) a list of each physician or health care
12-13 provider who has provided care to the enrollee and who may have
12-14 medical records relevant to the appeal;
12-15 (3) comply with the independent review organization's
12-16 determination with respect to the medical necessity or
12-17 appropriateness of health care items and services for an enrollee;
12-18 and
12-19 (4) pay for the independent review.
12-20 SECTION 4. Section 8, Article 21.58A, Insurance Code, is
12-21 amended by adding Subsection (f) to read as follows:
12-22 (f) Confidential information in the custody of a utilization
12-23 review agent may be provided to an independent review organization,
12-24 subject to rules and standards adopted by the commissioner under
12-25 Article 21.58C of this code.
13-1 SECTION 5. Subdivision (3), Subsection (a), Section 9, Texas
13-2 Health Maintenance Organization Act (Article 20A.09, Vernon's Texas
13-3 Insurance Code), is amended to read as follows:
13-4 (3) An evidence of coverage shall contain:
13-5 (A) no provisions or statements which are
13-6 unjust, unfair, inequitable, misleading, deceptive, which encourage
13-7 misrepresentation, or which are untrue, misleading, or deceptive as
13-8 defined in Section 14 of this Act; and
13-9 (B) a clear and complete statement, if a
13-10 contract, or a reasonably complete facsimile, if a certificate, of:
13-11 (i) the medical, health care services, or
13-12 single health care service and the issuance of other benefits, if
13-13 any, to which the enrollee is entitled under the health care plan
13-14 or single health care service plan;
13-15 (ii) any limitation on the services, kinds
13-16 of services, benefits, or kinds of benefits to be provided,
13-17 including any deductible or co-payment feature;
13-18 (iii) where and in what manner information
13-19 is available as to how services may be obtained; and
13-20 (iv) a clear and understandable
13-21 description of the health maintenance organization's methods for
13-22 resolving enrollee complaints, including the enrollee's right to
13-23 appeal denials of an adverse determination, as that term is defined
13-24 by Section 12A of this Act, to an independent review organization
13-25 and the procedures for making an appeal to an independent review
14-1 organization. Any subsequent changes may be evidenced in a
14-2 separate document issued to the enrollee.
14-3 SECTION 6. Section 12, Texas Health Maintenance Organization
14-4 Act (Article 20A.12, Vernon's Texas Insurance Code), is amended to
14-5 read as follows:
14-6 Sec. 12. COMPLAINT SYSTEM. (a) Every health maintenance
14-7 organization shall establish and maintain a complaint system to
14-8 provide reasonable procedures for the resolution of oral and
14-9 written complaints initiated by enrollees concerning health care
14-10 services.
14-11 (b) The commissioner [or board] may examine the [such]
14-12 complaint system.
14-13 SECTION 7. The Texas Health Maintenance Organization Act
14-14 (Chapter 20A, Vernon's Texas Insurance Code) is amended by adding
14-15 Section 12A to read as follows:
14-16 Sec. 12A. REVIEW OF ADVERSE DETERMINATIONS. (a) The
14-17 complaint system required by Section 12 of this Act must include:
14-18 (1) notification to the enrollee of the enrollee's
14-19 right to appeal an adverse determination to an independent review
14-20 organization;
14-21 (2) notification to the enrollee of the procedures for
14-22 appealing an adverse determination to an independent review
14-23 organization; and
14-24 (3) notification to an enrollee who has a
14-25 life-threatening condition of the enrollee's right to immediate
15-1 review by an independent review organization and the procedures to
15-2 obtain that review.
15-3 (b) The provisions of Article 21.58A, Insurance Code, that
15-4 relate to independent review apply to a health maintenance
15-5 organization under this section as if the health maintenance
15-6 organization were a utilization review agent.
15-7 (c) In this section:
15-8 (1) "Adverse determination" means determination by a
15-9 health maintenance organization that the health care services
15-10 furnished or proposed to be furnished to an enrollee are not
15-11 medically necessary.
15-12 (2) "Independent review organization" means an
15-13 organization selected as provided under Article 21.58C, Insurance
15-14 Code.
15-15 (3) "Life-threatening condition" has the meaning
15-16 assigned by Section 6, Article 21.58A, Insurance Code.
15-17 SECTION 8. Subchapter E, Chapter 21, Insurance Code, is
15-18 amended by adding Article 21.58C to read as follows:
15-19 Art. 21.58C. STANDARDS FOR INDEPENDENT REVIEW ORGANIZATIONS
15-20 Sec. 1. DEFINITIONS. In this article:
15-21 (1) "Life-threatening condition" has the meaning
15-22 assigned by Section 6, Article 21.58A of this code.
15-23 (2) "Payor" has the meaning assigned by Section 2,
15-24 Article 21.58A of this code.
15-25 Sec. 2. CERTIFICATION AND DESIGNATION OF INDEPENDENT REVIEW
16-1 ORGANIZATIONS. (a) The commissioner shall:
16-2 (1) promulgate standards and rules for:
16-3 (A) the certification, selection, and operation
16-4 of independent review organizations to perform independent review
16-5 described by Section 6, Article 21.58A of this code; and
16-6 (B) the suspension and revocation of the
16-7 certification;
16-8 (2) designate annually each organization that meets
16-9 the standards as an independent review organization;
16-10 (3) charge payors fees in accordance with this article
16-11 as necessary to fund the operations of independent review
16-12 organizations; and
16-13 (4) provide ongoing oversight of the independent
16-14 review organizations to ensure continued compliance with this
16-15 article and the standards and rules adopted under this article.
16-16 (b) The standards required by Subsection (a)(1) of this
16-17 section must ensure:
16-18 (1) the timely response of an independent review
16-19 organization selected under this article;
16-20 (2) the confidentiality of medical records transmitted
16-21 to an independent review organization for use in independent
16-22 reviews;
16-23 (3) the qualifications and independence of each health
16-24 care provider or physician making review determinations for an
16-25 independent review organization;
17-1 (4) the fairness of the procedures used by an
17-2 independent review organization in making the determinations; and
17-3 (5) timely notice to enrollees of the results of the
17-4 independent review, including the clinical basis for the
17-5 determination.
17-6 (c) The standards adopted under Subsection (a)(1) of this
17-7 section must include standards that require each independent review
17-8 organization to make its determination:
17-9 (1) not later than the earlier of:
17-10 (A) the 15th day after the date the independent
17-11 review organization receives the information necessary to make the
17-12 determination; or
17-13 (B) the 20th day after the date the independent
17-14 review organization receives the request that the determination be
17-15 made; and
17-16 (2) in the case of a life-threatening condition, not
17-17 later than the earlier of:
17-18 (A) the fifth day after the date the independent
17-19 review organization receives the information necessary to make the
17-20 determination; or
17-21 (B) the eighth day after the date the
17-22 independent review organization receives the request that the
17-23 determination be made.
17-24 (d) To be certified as an independent review organization
17-25 under this article, an organization must submit to the commissioner
18-1 an application in the form required by the commissioner. The
18-2 application must include:
18-3 (1) for an applicant that is publicly held, the name
18-4 of each stockholder or owner of more than five percent of any stock
18-5 or options;
18-6 (2) the name of any holder of bonds or notes of the
18-7 applicant that exceed $100,000;
18-8 (3) the name and type of business of each corporation
18-9 or other organization that the applicant controls or is affiliated
18-10 with and the nature and extent of the affiliation or control;
18-11 (4) the name and a biographical sketch of each
18-12 director, officer, and executive of the applicant and any entity
18-13 listed under Subdivision (3) of this subsection and a description
18-14 of any relationship the named individual has with:
18-15 (A) a health benefit plan;
18-16 (B) a health maintenance organization;
18-17 (C) an insurer;
18-18 (D) a utilization review agent;
18-19 (E) a nonprofit health corporation;
18-20 (F) a payor;
18-21 (G) a health care provider; or
18-22 (H) a group representing any of the entities
18-23 described by Paragraphs (A) through (G) of this subdivision;
18-24 (5) the percentage of the applicant's revenues that
18-25 are anticipated to be derived from reviews conducted under Section
19-1 6A, Article 21.58A of this code;
19-2 (6) a description of the areas of expertise of the
19-3 health care professionals making review determinations for the
19-4 applicant; and
19-5 (7) the procedures to be used by the independent
19-6 review organization in making review determinations with respect to
19-7 reviews conducted under Section 6A, Article 21.58A of this code.
19-8 (e) The independent review organization shall annually
19-9 submit the information required by Subsection (d) of this section.
19-10 If at any time there is a material change in the information
19-11 included in the application under Subsection (d) of this section,
19-12 the independent review organization shall submit updated
19-13 information to the commissioner.
19-14 (f) An independent review organization may not be a
19-15 subsidiary of, or in any way owned or controlled by, a payor or a
19-16 trade or professional association of payors.
19-17 (g) An independent review organization conducting a review
19-18 under Section 6A, Article 21.58A of this code is not liable for
19-19 damages arising from the determination made by the organization.
19-20 This subsection does not apply to an act or omission of the
19-21 independent review organization that is made in bad faith or that
19-22 involves gross negligence.
19-23 SECTION 9. Chapter 88, Civil Practice and Remedies Code, as
19-24 added by this Act, applies only to a cause of action that accrues
19-25 on or after the effective date of this Act. An action that accrues
20-1 before the effective date of this Act is governed by the law
20-2 applicable to the action immediately before the effective date of
20-3 this Act, and that law is continued in effect for that purpose.
20-4 SECTION 10. (a) The change in law made by Sections 2
20-5 through 4 and 6 through 8 of this Act applies only to an adverse
20-6 determination of a utilization review agent or health maintenance
20-7 organization made on or after the effective date of this Act.
20-8 (b) The change in law made by Section 5 of this Act to
20-9 Section 9, Texas Health Maintenance Organization Act (Article
20-10 20A.09, Vernon's Texas Insurance Code), applies only to an evidence
20-11 of coverage that is delivered, issued for delivery, or renewed on
20-12 or after January 1, 1998. An evidence of coverage that is
20-13 delivered, issued for delivery, or renewed before January 1, 1998,
20-14 is governed by the law as it existed immediately before the
20-15 effective date of this Act, and that law is continued in effect for
20-16 that purpose.
20-17 SECTION 11. This Act takes effect September 1, 1997.
20-18 SECTION 12. The importance of this legislation and the
20-19 crowded condition of the calendars in both houses create an
20-20 emergency and an imperative public necessity that the
20-21 constitutional rule requiring bills to be read on three several
20-22 days in each house be suspended, and this rule is hereby suspended.
S.B. No. 386
_______________________________ _______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 386 passed the Senate on
March 17, 1997, by a viva-voce vote; and that the Senate concurred
in House amendments on May 12, 1997, by the following vote:
Yeas 25, Nays 5.
_______________________________
Secretary of the Senate
I hereby certify that S.B. No. 386 passed the House, with
amendments, on May 8, 1997, by a non-record vote.
_______________________________
Chief Clerk of the House
Approved:
_______________________________
Date
_______________________________
Governor