SRC-JBJ H.B. 1194 76(R)   BILL ANALYSIS


Senate Research Center   H.B. 1194
By: Turner, Bob (Fraser)
Economic Development
5/10/1999
Engrossed


DIGEST 

The 75th Texas Legislature enacted legislation creating the statewide rural
health care system.  This system provided rural communities an alternative
to urban-based health maintenance organizations now operating in rural
Texas.  To improve the implementation of the system, changes could be made
as to the designation of rural areas and the regulation of care on a
prepaid basis.  H.B. 1194 would amend regulation of a statewide rural
health care system. 

PURPOSE

As proposed, H.B. 1194 amends regulation of a statewide rural health care
system. 

RULEMAKING AUTHORITY

This bill does not grant any additional rulemaking authority to a state
officer, institution, or agency. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Article 20C.02, Insurance Code, to redefine "rural
area." Requires the commissioner of insurance (commissioner) to consider
certain criteria in designating rural areas. 

SECTION 2.  Amends Article 20C.03, Insurance Code, to provide that the
statewide rural health care system (system) is established to provide
health care services, rather than to provide health care services, on a
prepaid basis, to enrollees who reside in rural areas. 

SECTION 3.  Amends Article 20C.04, Insurance Code, to require the system to
obtain a certificate of authority, if the system arranges for or provides
health care services to enrollees in exchange for a predetermined payment
per enrollee on a prepaid basis.  Deletes a requirement that makes a system
eligible for designation.  Authorizes the commissioner to provide, by rule,
exceptions to the application of provisions of Chapter 20A, V.T.I.S. (Texas
Health Maintenance Organization Act), relating to mileage, distance, and
network adequacy and scope.  Makes conforming changes. 

SECTION 4.  Amends Article 20C.07(a), Insurance Code, to provide that
members of the statewide rural health care system (board) serve terms that
expire December 1 of each even-numbered year, rather than February 1 of
each odd-numbered year. 

SECTION 5.  Amends Article 20C.08(f), Insurance Code, to authorize, rather
than require, the board to appoint an advisory committee to represent
certain health care services.  Sets forth meeting requirements for the
board.  Deletes composition requirements of the board. 

SECTION 6.  Amends Article 20C.14, Insurance Code, as follows:

Art. 20C.14.  New heading:  MANDATED PROVIDER.  Provides that the system
operates under certificate of authority of the Texas Health Maintenance
Organization Act in regards to certain Medicaid reimbursements.  Deletes
provisions that make this article inapplicable to certain contracts.  Makes
conforming changes. 

SECTION 7. Effective date: September 1, 1999.
  Makes application of this Act prospective.
 
SECTION 8.Emergency clause.