By:  Cain                                             S.B. No. 1651

         Line and page numbers may not match official copy.

         Bill not drafted by TLC or Senate E&E.

                                A BILL TO BE ENTITLED

                                       AN ACT

 1-1     relating to improving access to health care for the citizens of

 1-2     Texas by providing for the reimbursement and use of particular

 1-3     health care practitioners who are licensed by the state to provide

 1-4     certain services.

 1-5           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

 1-6           SECTION 1.  Amend Article 3.70-2(B), Insurance Code, to read

 1-7     as follows:

 1-8           (B)  No policy of accident and sickness insurance shall make

 1-9     benefits contingent upon treatment or examination by a particular

1-10     practitioner or by particular practitioners of the healing arts

1-11     hereinafter designated unless such policy contains a provision

1-12     designating the practitioner or practitioners who will be

1-13     recognized by the insurer and those who will not be recognized by

1-14     the insurer.  Such provision may be located in the "Exceptions" or

1-15     "Exceptions and Reductions" provisions, or elsewhere in the policy,

1-16     or by endorsement attached to the policy, at the insurer's option.

1-17     In designating the practitioners who will and will not be

1-18     recognized, such provision shall use the following terms:  Doctor

1-19     of Medicine, Doctor of Osteopathy, Doctor of Dentistry, Doctor of

1-20     Chiropractic, Doctor of Optometry, Doctor of Podiatry, Licensed

1-21     Audiologist, Licensed Speech-language Pathologist, Doctor of

 2-1     Psychology, Licensed Master Social Worker--Advanced Clinical

 2-2     Practitioner, Licensed Dietitian, Licensed Professional Counselor,

 2-3     Licensed Marriage and Family Therapist, Licensed Chemical

 2-4     Dependency Counselor, Licensed Hearing Aid Fitter and Dispenser,

 2-5     Licensed Occupational Therapist, Licensed Physical Therapist, and

 2-6     Licensed Psychological Associate.

 2-7           For purposes of this Act, such designations shall have the

 2-8     following meanings:

 2-9           Doctor of Medicine:  One licensed by the Texas State Board of

2-10     Medical Examiners on the basis of the degree "Doctor of Medicine";

2-11           Doctor of Osteopathy:  One licensed by the Texas State Board

2-12     of Medical Examiners on the basis of the degree of "Doctor of

2-13     Osteopathy";

2-14           Doctor of Dentistry:  One licensed by the State Board of

2-15     Dental Examiners;

2-16           Doctor of Chiropractic:  One licensed by the Texas Board of

2-17     Chiropractic Examiners;

2-18           Doctor of Optometry:  One licensed by the Texas Optometry

2-19     Board;

2-20           Doctor of Podiatry:  One licensed by the Texas State Board of

2-21     Podiatric Medical Examiners;

2-22           Licensed Audiologist:  One with a master's or doctorate

2-23     degree in audiology from an accredited college or university and

2-24     who is licensed as an audiologist by the State Committee of

2-25     Examiners for Speech-Language Pathology and Audiology;

 3-1           Licensed Speech-language Pathologist:  One with a master's or

 3-2     doctorate degree in speech pathology or speech-language pathology

 3-3     from an accredited college or university and who is licensed as a

 3-4     speech-language pathologist by the State Committee of Examiners for

 3-5     Speech-Language Pathology and Audiology;

 3-6           Doctor in Psychology:  One licensed by the Texas State Board

 3-7     of Examiners of Psychologists and certified as a Health Service

 3-8     Provider;

 3-9           Licensed Master Social Worker--Advanced Clinical

3-10     Practitioner:  One licensed by the Texas State Board of Social

3-11     Worker Examiners as a Licensed Master Social Worker with the order

3-12     of recognition of Advanced Clinical Practitioner;

3-13           Licensed Dietitian:  One licensed by the Texas State Board of

3-14     Examiners of Dietitians;

3-15           Licensed Professional Counselor:  One licensed by the Texas

3-16     State Board of Examiners of Professional Counselors;

3-17           Licensed Marriage and Family Therapist:  One licensed by the

3-18     Texas State Board of Examiners of Marriage and Family Therapists;

3-19           Licensed Chemical Dependency Counselor:  One licensed by the

3-20     Texas Commission on Alcohol and Drug Abuse;

3-21           Licensed Hearing Aid Fitter and Dispenser:  One licensed by

3-22     the Texas Board of Examiners in the Fitting and Dispensing of

3-23     Hearing Aids; and

3-24           Licensed Occupational Therapist:  One licensed by the Texas

3-25     Board of Occupational Therapy Examiners;

 4-1           Licensed Physical Therapist:  One licensed by the Texas Board

 4-2     of Physical Therapy Examiners; and

 4-3           Licensed Psychological Associate:  One licensed by the Texas

 4-4     State Board of Examiners of Psychologists and practicing under the

 4-5     supervision of a licensed psychologist.

 4-6           SECTION 2.  Amend Section 1 of Article 21.52, Insurance Code,

 4-7     by adding 2 appropriately lettered subsections to read as follows:

 4-8                 ()  "occupational therapist" means a person who is

 4-9     licensed to practice occupational therapy by the Texas Board of

4-10     Occupational Therapy Examiners;

4-11                 ()  "physical therapist" means a person who practices

4-12     physical therapy and is licensed by the Texas Board of Physical

4-13     Therapy Examiners.

4-14           SECTION 3.  Amend Section 3 of Article 21.52, Insurance Code,

4-15     as amended by Acts 1995, 74th Legislature, Chapter 429, Section 2,

4-16     to read as follows:

4-17           Sec. 3.  Any person who is issued, who is a party to, or who

4-18     is a beneficiary under any health insurance policy delivered,

4-19     renewed, or issued for delivery in this state by any insurance

4-20     company, association, or organization to which this article applies

4-21     may select a licensed doctor of podiatric medicine, a licensed

4-22     dentist, or a doctor of chiropractic to perform the medical or

4-23     surgical services or procedures scheduled in the policy which fall

4-24     within the scope of the license of that practitioner, a licensed

4-25     doctor of optometry to perform the services or procedures scheduled

 5-1     in the policy which fall within the scope of the license of that

 5-2     doctor of optometry, an occupational therapist to provide the

 5-3     health care services scheduled in the policy which fall within the

 5-4     scope of the license of that provider, a physical therapist to

 5-5     provide the health care services in the policy which fall within

 5-6     the scope of the license of that provider, a licensed audiologist

 5-7     to measure hearing for the purpose of determining the presence or

 5-8     extent of a hearing loss and to provide aural rehabilitation

 5-9     services to a person with a hearing loss if those services or

5-10     procedures are scheduled in the policy, a licensed speech-language

5-11     pathologist to evaluate speech and language and to provide

5-12     habilitative and rehabilitative services to restore speech or

5-13     language loss or to correct a speech or language impairment if

5-14     those services or procedures are scheduled in the policy, a

5-15     licensed master social worker--advanced clinical practitioner to

5-16     provide the services that fall within the scope of the license of

5-17     such certified practitioner and which are specified as services

5-18     within the terms of the policy of insurance, including the

5-19     provision of direct, diagnostic, preventive, or clinical services

5-20     to individuals, families, and groups whose functioning is

5-21     threatened or affected by social or psychological stress or health

5-22     impairment, if those services or procedures are scheduled in the

5-23     policy, a licensed dietitian including a provisional licensed

5-24     dietitian under a licensed dietitian's supervision to provide the

5-25     services that fall within the scope of the license of that

 6-1     dietitian if those services are scheduled in the policy, a licensed

 6-2     professional counselor to provide the services that fall within the

 6-3     scope of the license of that professional if those services are

 6-4     scheduled in the policy, a licensed marriage and family therapist

 6-5     to provide the services that fall within the scope of the license

 6-6     of that professional if those services are scheduled in the policy,

 6-7     a psychologist to perform the services or procedures scheduled in

 6-8     the policy that fall within the scope of the license of that

 6-9     psychologist, a licensed chemical dependency counselor to perform

6-10     the services or procedures scheduled in the policy that fall within

6-11     the scope of the license of that practitioner, or a licensed

6-12     hearing aid fitter and dispenser to provide the services or

6-13     procedures scheduled in the policy that fall within the scope of

6-14     the license of that practitioner.  The services of a licensed

6-15     master social worker--advanced clinical practitioner, licensed

6-16     professional counselor, or licensed marriage and family therapist

6-17     that are included in this Act may require a professional

6-18     recommendation by a doctor of medicine or doctor of osteopathy

6-19     unless the health insurance policy terms do not require such a

6-20     recommendation.  The payment or reimbursement by the insurance

6-21     company, association, or organization for those services or

6-22     procedures in accordance with the payment schedule or the payment

6-23     provisions in the policy shall not be denied because the same were

6-24     performed by a licensed doctor of podiatric medicine, a licensed

6-25     doctor of optometry, a licensed doctor of chiropractic, a licensed

 7-1     dentist, an occupational therapist, a physical therapist, a

 7-2     licensed audiologist, a licensed speech-language pathologist, a

 7-3     licensed master social worker--advanced clinical practitioner, a

 7-4     licensed dietitian, a licensed professional counselor, a licensed

 7-5     marriage and family therapist, a psychologist, a licensed chemical

 7-6     dependency counselor, or a licensed hearing aid fitter and

 7-7     dispenser.  There shall not be any classification, differentiation,

 7-8     or other discrimination in the payment schedule or the payment

 7-9     provisions in a health insurance policy, nor in the amount or

7-10     manner of payment or reimbursement thereunder, between scheduled

7-11     services or procedures when performed by a doctor of podiatric

7-12     medicine, a doctor of optometry, a doctor of chiropractic, a

7-13     licensed dentist, an occupational therapist, a physical therapist,

7-14     a licensed audiologist, a licensed speech-language pathologist, a

7-15     licensed master social worker--advanced clinical practitioner, a

7-16     licensed dietitian, a licensed professional counselor, a licensed

7-17     marriage and family therapist, a psychologist, a licensed chemical

7-18     dependency counselor, or a licensed hearing aid fitter and

7-19     dispenser which fall within the scope of the license or

7-20     certification and the same services or procedures when performed by

7-21     any other practitioner of the healing arts whose services or

7-22     procedures are covered by the policy.  Any provision in a health

7-23     insurance policy contrary to or in conflict with the provisions of

7-24     this article shall, to the extent of the conflict, be void, but

7-25     such invalidity shall not affect the validity of the other

 8-1     provisions of this policy.  Any presently approved policy form

 8-2     containing any provision in conflict with the requirements of this

 8-3     Act shall be brought into compliance with this Act by the use of

 8-4     riders and endorsements which have been approved by the State Board

 8-5     of Insurance or by the filing of new or revised policy forms for

 8-6     approval by the State Board of Insurance.

 8-7           SECTION 4.  Amend Section 3 of Article 21.52, Insurance Code,

 8-8     as amended by Acts 1995, 74th Legislature, Chapter 541, Section 3,

 8-9     to read as follows:

8-10           Sec. 3.  Any person who is issued, who is a party to, or who

8-11     is a beneficiary under any health insurance policy delivered,

8-12     renewed, or issued for delivery in this state by any insurance

8-13     company, association, or organization to which this article applies

8-14     may select a licensed doctor of podiatric medicine, a licensed

8-15     dentist, or a doctor of chiropractic to perform the medical or

8-16     surgical services or procedures scheduled in the policy which fall

8-17     within the scope of the license of that practitioner, a licensed

8-18     doctor of optometry to perform the services or procedures scheduled

8-19     in the policy which fall within the scope of the license of that

8-20     doctor of optometry, an occupational therapist to provide the

8-21     services scheduled in the policy which fall within the scope of the

8-22     license of that occupational therapist, a physical therapist to

8-23     provide the services scheduled in the policy which fall within the

8-24     scope of license of that physical therapist, a licensed audiologist

8-25     to measure hearing for the purpose of determining the presence or

 9-1     extent of a hearing loss and to provide aural rehabilitation

 9-2     services to a person with a hearing loss if those services or

 9-3     procedures are scheduled in the policy, a licensed speech-language

 9-4     pathologist to evaluate speech and language and to provide

 9-5     habilitative and rehabilitative services to restore speech or

 9-6     language loss or to correct a speech or language impairment if

 9-7     those services or procedures are scheduled in the policy, a

 9-8     licensed master social worker--advanced clinical practitioner to

 9-9     provide the services that fall within the scope of the license of

9-10     such certified practitioner and which are specified as services

9-11     within the terms of the policy of insurance, including the

9-12     provision of direct, diagnostic, preventive, or clinical services

9-13     to individuals, families, and groups whose functioning is

9-14     threatened or affected by social or psychological stress or health

9-15     impairment, if those services or procedures are scheduled in the

9-16     policy, a licensed dietitian including a provisional licensed

9-17     dietitian under a licensed dietitian's supervision to provide the

9-18     services that fall within the scope of the license of that

9-19     dietitian if those services are scheduled in the policy, a licensed

9-20     professional counselor to provide the services that fall within the

9-21     scope of the license of that professional if those services are

9-22     scheduled in the policy, a licensed marriage and family therapist

9-23     to provide the services that fall within the scope of the license

9-24     of that professional if those services are scheduled in the policy,

9-25     a psychologist to perform the services or procedures scheduled in

 10-1    the policy that fall within the scope of the license of that

 10-2    psychologist, a licensed hearing aid fitter and dispenser to

 10-3    provide the services or procedures scheduled in the policy that

 10-4    fall within the scope of the license of that practitioner, or a

 10-5    licensed psychological associate to provide the services that fall

 10-6    within the scope of the license of that professional if those

 10-7    services are scheduled in the policy.  The services of a licensed

 10-8    master social worker--advanced clinical practitioner, licensed

 10-9    professional counselor, or licensed marriage and family therapist

10-10    that are included in this Act may require a professional

10-11    recommendation by a doctor of medicine or doctor of osteopathy

10-12    unless the health insurance policy terms do not require such a

10-13    recommendation.  The payment or reimbursement by the insurance

10-14    company, association, or organization for those services or

10-15    procedures in accordance with the payment schedule or the payment

10-16    provisions in the policy shall not be denied because the same were

10-17    performed by a licensed doctor of podiatric medicine, a licensed

10-18    doctor of optometry, a licensed doctor of chiropractic, a licensed

10-19    dentist, an occupational therapist, a physical therapist, a

10-20    licensed audiologist, a licensed speech-language pathologist, a

10-21    licensed master social worker--advanced clinical practitioner, a

10-22    licensed dietitian, a licensed professional counselor, a licensed

10-23    marriage and family therapist, a psychologist, a licensed

10-24    psychological associate, or a licensed hearing aid fitter and

10-25    dispenser.  There shall not be any classification, differentiation,

 11-1    or other discrimination in the payment schedule or the payment

 11-2    provisions in a health insurance policy, nor in the amount or

 11-3    manner of payment or reimbursement thereunder, between scheduled

 11-4    services or procedures when performed by a doctor of podiatric

 11-5    medicine, a doctor of optometry, a doctor of chiropractic, a

 11-6    licensed dentist, an occupational therapist, a physical therapist,

 11-7    a licensed audiologist, a licensed speech-language pathologist, a

 11-8    licensed master social worker--advanced clinical practitioner, a

 11-9    licensed dietitian, a licensed professional counselor, a licensed

11-10    marriage and family therapist, a psychologist, a licensed

11-11    psychological associate, or a licensed hearing aid fitter and

11-12    dispenser which fall within the scope of his license or

11-13    certification and the same services or procedures when performed by

11-14    any other practitioner of the healing arts whose services or

11-15    procedures are covered by the policy.  Any provision in a health

11-16    insurance policy contrary to or in conflict with the provisions of

11-17    this article shall, to the extent of the conflict, be void, but

11-18    such invalidity shall not affect the validity of the other

11-19    provisions of this policy.  Any presently approved policy form

11-20    containing any provision in conflict with the requirements of this

11-21    Act shall be brought into compliance with this Act by the use of

11-22    riders and endorsements which have been approved by the State Board

11-23    of Insurance or by the filing of new or revised policy forms for

11-24    approval by the State Board of Insurance.

11-25          SECTION 5.  This Act takes effect September 1, 1997.

 12-1          SECTION 6.  The importance of this legislation and the

 12-2    crowded condition of the calendars in both houses create an

 12-3    emergency and an imperative public necessity that the

 12-4    constitutional rule requiring bills to be read on three several

 12-5    days in each house be suspended, and this rule is hereby suspended.