SRC-JBJ C.S.S.B. 569 76(R)BILL ANALYSIS


Senate Research CenterC.S.S.B. 569
76R11574 DB-DBy: Nelson
Economic Development
4/7/1999
Committee Report (Substituted)


DIGEST 

Currently, certain health benefit plans maintain reimbursement requirements
for an enrollee or a health provider.  In a mental health plan, for
example, a company may require a representative to observe an enrollee's
psychotherapy session or require the mental health provider to submit its
progress notes from the session.  Although Texas Department of Insurance
(TDI) rules prohibit utilization review agents from using progress notes or
observing therapy sessions, codification of the TDI rules would expand some
prohibitions against certain mental health field practices.  C.S.S.B. 569
would prohibit an insurance company representative from observing therapy
sessions and prevent certain providers from being required to submit their
notes as a condition of treatment approval. 

PURPOSE

As proposed, C.S.S.B. 569 prohibits insurance company representatives from
observing therapy sessions and prevents certain providers from being
required to submit their notes as a condition of reimbursement.  

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 Section 4, Article 21.58A, Insurance Code, by adding
Subsection (o), to prohibit a utilization review agent from requiring the
observation of a psychotherapy session or submission of mental health
therapist's process or progress notes.  Authorizes the agent to require
submission of such records to demonstrate policy coverage.   

SUMMARY OF COMMITTEE CHANGES

SECTION 1.

Deletes proposed additions to Section 4, Article 21.58A, Insurance,
regarding restrictions applicable to certain mental health services.