By:  Madla                                            S.B. No. 1029
         99S0715/1                           
                                A BILL TO BE ENTITLED
                                       AN ACT
 1-1     relating to the recognition and selection of certain practitioners
 1-2     under a policy of health and accident insurance.
 1-3           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-4           SECTION 1.  Subsection (B), Section 2, Chapter 397, Acts of
 1-5     the 54th Legislature, Regular Session, 1955 (Article 3.70-2,
 1-6     Vernon's Texas Insurance Code), as amended by Chapters 946 and
 1-7     1260, Acts of the 75th Legislature, Regular Session, 1997, is
 1-8     conformed and amended to read as follows:
 1-9           (B)  No policy of accident and sickness insurance shall make
1-10     benefits contingent upon treatment or examination by a particular
1-11     practitioner or by particular practitioners of the healing arts
1-12     hereinafter designated unless such policy contains a provision
1-13     designating the practitioner or practitioners who will be
1-14     recognized by the insurer and those who will not be recognized by
1-15     the insurer.  Such provision may be located in the "Exceptions" or
1-16     "Exceptions and Reductions" provisions, or elsewhere in the policy,
1-17     or by endorsement attached to the policy, at the insurer's option.
1-18     In designating the practitioners who will and will not be
1-19     recognized, such provision shall use the following terms:  Doctor
1-20     of Medicine, Doctor of Osteopathy, Doctor of Dentistry, Doctor of
1-21     Chiropractic, Doctor of Optometry, Doctor of Podiatry, Licensed
1-22     Audiologist, Licensed Speech-language Pathologist, Doctor in
1-23     Psychology, Licensed Master Social Worker--Advanced Clinical
1-24     Practitioner, Licensed Dietitian, Licensed Professional Counselor,
 2-1     Licensed Marriage and Family Therapist, Licensed Chemical
 2-2     Dependency Counselor, Licensed Acupuncturist or Doctor of Oriental
 2-3     Medicine, Licensed Hearing Aid Fitter and Dispenser, Licensed
 2-4     Occupational Therapist, Licensed Physical Therapist, Advanced
 2-5     Practice Nurse, Physician Assistant, and Licensed Psychological
 2-6     Associate.
 2-7           For purposes of this Act, such designations shall have the
 2-8     following meanings:
 2-9           Doctor of Medicine:  One licensed by the Texas State Board of
2-10     Medical Examiners on the basis of the degree "Doctor of Medicine";
2-11           Doctor of Osteopathy:  One licensed by the Texas State Board
2-12     of Medical Examiners on the basis of the degree of "Doctor of
2-13     Osteopathy";
2-14           Doctor of Dentistry:  One licensed by the State Board of
2-15     Dental Examiners;
2-16           Doctor of Chiropractic:  One licensed by the Texas Board of
2-17     Chiropractic Examiners;
2-18           Doctor of Optometry:  One licensed by the Texas Optometry
2-19     Board;
2-20           Doctor of Podiatry:  One licensed by the Texas State Board of
2-21     Podiatric Medical Examiners;
2-22           Licensed Audiologist:  One with a master's or doctorate
2-23     degree in audiology from an accredited college or university and
2-24     who is licensed as an audiologist by the State Board of Examiners
2-25     for Speech-Language Pathology and Audiology;
2-26           Licensed Speech-language Pathologist:  One with a master's or
 3-1     doctorate degree in speech pathology or speech-language pathology
 3-2     from an accredited college or university and who is licensed as a
 3-3     speech-language pathologist by the State Board of Examiners for
 3-4     Speech-Language Pathology and Audiology;
 3-5           Doctor in Psychology:  One licensed by the Texas State Board
 3-6     of Examiners of Psychologists and certified as a Health Service
 3-7     Provider;
 3-8           Licensed Master Social Worker--Advanced Clinical
 3-9     Practitioner:  One licensed by the Texas State Board of Social
3-10     Worker Examiners as a Licensed Master Social Worker with the order
3-11     of recognition of Advanced Clinical Practitioner;
3-12           Licensed Dietitian:  One licensed by the Texas State Board of
3-13     Examiners of Dietitians;
3-14           Licensed Professional Counselor:  One licensed by the Texas
3-15     State Board of Examiners of Professional Counselors;
3-16           Licensed Marriage and Family Therapist:  One licensed by the
3-17     Texas State Board of Examiners of Marriage and Family Therapists;
3-18           Licensed Chemical Dependency Counselor:  One licensed by the
3-19     Texas Commission on Alcohol and Drug Abuse;
3-20           Licensed Acupuncturist or Doctor of Oriental Medicine:  One
3-21     licensed by the Texas State Board of Medical Examiners;
3-22           Licensed Hearing Aid Fitter and Dispenser:  One licensed by
3-23     the Texas Committee of Examiners in the Fitting and Dispensing of
3-24     Hearing Instruments;
3-25           Licensed Occupational Therapist:  One licensed by the Texas
3-26     Board of Occupational Therapy Examiners;
 4-1           Licensed Physical Therapist:  One licensed by the Texas Board
 4-2     of Physical Therapy Examiners;
 4-3           Advanced Practice Nurse:  One licensed by the Board of Nurse
 4-4     Examiners as a registered nurse and recognized by that board as an
 4-5     advanced practice nurse;
 4-6           Physician Assistant:  One licensed by the Texas State Board
 4-7     of Physician Assistant Examiners; and
 4-8           Licensed Psychological Associate:  One licensed by the Texas
 4-9     State Board of Examiners of Psychologists and practicing under the
4-10     supervision of a licensed psychologist.
4-11           SECTION 2.  Section 3, Article 21.52, Insurance Code, as
4-12     amended by Chapters 429 and 541, Acts of the 74th Legislature,
4-13     Regular Session, 1995, and Chapter 946, Acts of the 75th
4-14     Legislature, Regular Session, 1997, is conformed and amended to
4-15     read as follows:
4-16           Sec. 3.  Selection of practitioners.  Any person who is
4-17     issued, who is a party to, or who is a beneficiary under any health
4-18     insurance policy delivered, renewed, or issued for delivery in this
4-19     state by any insurance company, association, or organization to
4-20     which this article applies may select a licensed doctor of
4-21     podiatric medicine, a licensed dentist, or a doctor of chiropractic
4-22     to perform the medical or surgical services or procedures scheduled
4-23     in the policy which fall within the scope of the license of that
4-24     practitioner, a licensed doctor of optometry to perform the
4-25     services or procedures scheduled in the policy which fall within
4-26     the scope of the license of that doctor of optometry, an
 5-1     occupational therapist to provide the health care services
 5-2     scheduled in the policy which fall within the scope of the license
 5-3     of that occupational therapist, a physical therapist to provide the
 5-4     health care services scheduled in the policy which fall within the
 5-5     scope of the license of that physical therapist, a licensed
 5-6     audiologist to measure hearing for the purpose of determining the
 5-7     presence or extent of a hearing loss and to provide aural
 5-8     rehabilitation services to a person with a hearing loss if those
 5-9     services or procedures are scheduled in the policy, a licensed
5-10     speech-language pathologist to evaluate speech and language and to
5-11     provide habilitative and rehabilitative services to restore speech
5-12     or language loss or to correct a speech or language impairment if
5-13     those services or procedures are scheduled in the policy, a
5-14     licensed master social worker--advanced clinical practitioner to
5-15     provide the services that fall within the scope of the license of
5-16     such certified practitioner and which are specified as services
5-17     within the terms of the policy of insurance, including the
5-18     provision of direct, diagnostic, preventive, or clinical services
5-19     to individuals, families, and groups whose functioning is
5-20     threatened or affected by social or psychological stress or health
5-21     impairment, if those services or procedures are scheduled in the
5-22     policy, a licensed dietitian including a provisional licensed
5-23     dietitian under a licensed dietitian's supervision to provide the
5-24     services that fall within the scope of the license of that
5-25     dietitian if those services are scheduled in the policy, a licensed
5-26     professional counselor to provide the services that fall within the
 6-1     scope of the license of that professional if those services are
 6-2     scheduled in the policy, a licensed marriage and family therapist
 6-3     to provide the services that fall within the scope of the license
 6-4     of that professional if those services are scheduled in the policy,
 6-5     a psychologist to perform the services or procedures scheduled in
 6-6     the policy that fall within the scope of the license of that
 6-7     psychologist, a licensed chemical dependency counselor to perform
 6-8     the services or procedures scheduled in the policy that fall within
 6-9     the scope of the license of that practitioner, a licensed
6-10     acupuncturist or doctor of oriental medicine to perform the
6-11     services or procedures scheduled in the policy that fall within the
6-12     scope of the license of that practitioner, a licensed hearing aid
6-13     fitter and dispenser to provide the services or procedures
6-14     scheduled in the policy that fall within the scope of the license
6-15     of that practitioner, or a licensed psychological associate to
6-16     provide the services that fall within the scope of the license of
6-17     that professional if those services are scheduled in the policy.
6-18     The services of a licensed master social worker--advanced clinical
6-19     practitioner, licensed professional counselor, or licensed marriage
6-20     and family therapist that are included in this Act may require a
6-21     professional recommendation by a doctor of medicine or doctor of
6-22     osteopathy unless the health insurance policy terms do not require
6-23     such a recommendation.  The payment or reimbursement by the
6-24     insurance company, association, or organization for those services
6-25     or procedures in accordance with the payment schedule or the
6-26     payment provisions in the policy shall not be denied because the
 7-1     same were performed by a licensed doctor of podiatric medicine, a
 7-2     licensed doctor of optometry, a licensed doctor of chiropractic, a
 7-3     licensed dentist, an occupational therapist, a physical therapist,
 7-4     a licensed audiologist, a licensed speech-language pathologist, a
 7-5     licensed master social worker--advanced clinical practitioner, a
 7-6     licensed dietitian, a licensed professional counselor, a licensed
 7-7     marriage and family therapist, a psychologist, a licensed
 7-8     psychological associate, a licensed chemical dependency counselor,
 7-9     a licensed acupuncturist or doctor of oriental medicine, or a
7-10     licensed hearing aid fitter and dispenser.  There shall not be any
7-11     classification, differentiation, or other discrimination in the
7-12     payment schedule or the payment provisions in a health insurance
7-13     policy, nor in the amount or manner of payment or reimbursement
7-14     thereunder, between scheduled services or procedures when performed
7-15     by a doctor of podiatric medicine, a doctor of optometry, a doctor
7-16     of chiropractic, a licensed dentist, an occupational therapist, a
7-17     physical therapist, a licensed audiologist, a licensed
7-18     speech-language pathologist, a licensed master social
7-19     worker--advanced clinical practitioner, a licensed dietitian, a
7-20     licensed professional counselor, a licensed marriage and family
7-21     therapist, a psychologist, a licensed psychological associate, a
7-22     licensed chemical dependency counselor, a licensed acupuncturist or
7-23     doctor of oriental medicine, or a licensed hearing aid fitter and
7-24     dispenser which fall within the scope of his license or
7-25     certification and the same services or procedures when performed by
7-26     any other practitioner of the healing arts whose services or
 8-1     procedures are covered by the policy.  Any provision in a health
 8-2     insurance policy contrary to or in conflict with the provisions of
 8-3     this article shall, to the extent of the conflict, be void, but
 8-4     such invalidity shall not affect the validity of the other
 8-5     provisions of this policy.  Any presently approved policy form
 8-6     containing any provision in conflict with the requirements of this
 8-7     Act shall be brought into compliance with this Act by the use of
 8-8     riders and endorsements which have been approved by the State Board
 8-9     of Insurance or by the filing of new or revised policy forms for
8-10     approval by the State Board of Insurance.
8-11           SECTION 3.  This Act takes effect September 1, 1999.
8-12           SECTION 4.  The importance of this legislation and the
8-13     crowded condition of the calendars in both houses create an
8-14     emergency and an imperative public necessity that the
8-15     constitutional rule requiring bills to be read on three several
8-16     days in each house be suspended, and this rule is hereby suspended.