HBA-TYH H.B. 3180 76(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 3180
By: Lewis, Glenn
Insurance
4/6/1999
Introduced



BACKGROUND AND PURPOSE 

The market power of certain health maintenance organizations (HMOs) and
other managed care organizations may allow them to dictate a provision
providing for "all products."  Under this provision, if a physician or
other health provider wishes to be a participant in one product they must
also be a provider in all of the products, including an HMO product offered
by the HMO or managed care organization.  By including a beneficiary and
health care provider as potential subjects of an unfair settlement
practice, H.B. 3180 clarifies that if a health benefit plan offers multiple
products, it may not tie participation in one product to a requirement for
participation in one or more of the plan's other products. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that this bill does
not expressly delegate any additional rulemaking authority to a state
officer, department, agency, or institution. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 10(10), Article 21.21, Insurance Code, to define
unfair settlement practices as engaging in any of the enumerated unfair
settlement practices with respect to a claim by an insured, beneficiary,
health care provider, or person or entity with which one has contracted to
provide services to an insured or beneficiary, as appropriate.  Makes a
conforming change. 

SECTION 2.  Effective date: September 1, 1999.

SECTION 3.  Emergency clause.