SRC-PNG S.B. 1884 76(R)   BILL ANALYSIS


Senate Research Center   S.B. 1884
By: Sibley
Economic Development
4/26/1999
As Filed


DIGEST 

Currently, the Health Care Liability Act, passed by the legislature in
1997, allows an individual to sue a health insurance carrier, health
maintenance organization, or managed care entity for damages resulting from
the entity's failure to exercise ordinary care when making a health care
treatment decision.  In addition, the Act requires that an insured or
enrollee submit a claim to an independent review organization before
maintaining an action under the Act if the review is requested by the
managed care entity.  Case law has held that the independent review
mechanism contained in the legislation is preempted by federal law as it
relates to certain employee benefit plans governed by the Employee
Retirement Income Security Act of 1974. This bill would create a separate
voluntary independent review mechanism within the Health Care Liability Act
of 1997, that would apply only at the request of a managed care entity to
an insured or enrollee as long as the entity agrees to comply with certain
provisions relating to independent reviews. 

PURPOSE

As proposed, S.B. 1884 creates a separate voluntary independent review
mechanism within the Health Care Liability Act of 1997, that would apply
only at the request of a managed care entity to an insured or enrollee as
long as the entity agrees to comply with certain provisions relating to
independent reviews. 

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 88.003, Civil Practice and Remedies Code, to
require a review conducted under Subsection (c) as requested by a health
insurance carrier, health maintenance organization, or managed care entity
to be performed in accordance with Article 21.58C, Insurance Code.
Requires the health insurance carrier, health maintenance organization, or
managed care entity requesting the review to agree to comply with
Subdivisions (2), (3) and (4) of Section 6A, Article 21.58A, Insurance
Code.  Makes conforming and nonsubstantive changes. 

SECTION 2. Effective date: September 1, 1999.

SECTION 3. Makes application of this Act prospective.

SECTION 4. Emergency clause.