By Smithee                                            H.B. No. 2748
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to coverage for certain care for children provided through
 1-3     a health maintenance organization.
 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-5           SECTION 1.  The Texas Health Maintenance Organization Act
 1-6     (Chapter 20A, Vernon's Texas Insurance Code) is amended by adding
 1-7     Section 9E to read as follows:
 1-8           Sec. 9E.  WELL-CHILD CARE FROM BIRTH.  (a)  In this Act,
 1-9     "well-child care from birth" has the meaning used under Section
1-10     1302,  Public Health Service Act (42 U.S.C. Section 300e-1), and
1-11     its subsequent amendments, and includes newborn screening required
1-12     by the Texas Department of Health at birth through the 14th day of
1-13     life.
1-14           (b)  Each health maintenance organization shall ensure that
1-15     each health care plan provided by the organization includes
1-16     well-child care from birth that complies with the federal
1-17     requirements adopted under Chapter XI, Public Health Service Act
1-18     (42 U.S.C.  Section 300e et seq.), and its subsequent amendments,
1-19     and the rules adopted by the Texas Department of Health to
1-20     implement those requirements.
1-21           SECTION 2.  The Texas Health Maintenance Organization Act
1-22     (Chapter 20A, Vernon's Texas Insurance Code) is amended by adding
1-23     Section 9F to read as follows:
1-24           Sec. 9F.  USE OF PEDIATRICIAN AS PRIMARY CARE PHYSICIAN.  (a)
 2-1     Notwithstanding any other provision of this chapter, a parent of a
 2-2     minor enrollee may choose and use any pediatrician as the minor
 2-3     enrollee's primary care physician without paying an additional fee
 2-4     or premium.
 2-5           (b)  The parent shall notify the health maintenance
 2-6     organization of the parent's choice of pediatrician in the manner
 2-7     prescribed by the Texas Department of Insurance.  The notice
 2-8     required under this subsection must:
 2-9                 (1)  include all information required by the Texas
2-10     Department of Insurance, including a statement indicating the name
2-11     of the pediatrician; and
2-12                 (2)  be signed by the parent and the pediatrician
2-13     interested in serving as the minor enrollee's primary care
2-14     physician.
2-15           (c)  To be eligible to serve as the minor enrollee's primary
2-16     care physician, the pediatrician must:
2-17                 (1)  meet the health maintenance organization's
2-18     requirements for participation as a primary care physician; and
2-19                 (2)  be willing to coordinate all of the minor
2-20     enrollee's health care needs.
2-21           SECTION 3.  Section 9F, Texas Health Maintenance Organization
2-22     Act (Chapter 20A, Vernon's Texas Insurance Code),  as added by this
2-23     Act, applies only to an evidence of coverage delivered, issued for
2-24     delivery, or renewed on or after January 1, 2000.  An evidence of
2-25     coverage delivered, issued for delivery, or renewed before January
2-26     1, 2000, is governed by the law as it existed immediately before
2-27     the effective date of this Act, and that law is continued in effect
 3-1     for that purpose.
 3-2           SECTION 4.  The importance of this legislation and the
 3-3     crowded condition of the calendars in both houses create an
 3-4     emergency and an imperative public necessity that the
 3-5     constitutional rule requiring bills to be read on three several
 3-6     days in each house be suspended, and this rule is hereby suspended,
 3-7     and that this Act take effect and be in force from and after its
 3-8     passage, and it is so enacted.