By Fraser S.B. No. 1063
76R3254 AJA-F
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the operation of a statewide rural health care system.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Article 20C.02, Insurance Code, is amended to
1-5 read as follows:
1-6 Art. 20C.02. DEFINITIONS. (a) In this chapter:
1-7 (1) "Board" means the board of directors of the
1-8 system.
1-9 (2) "Enrollee" means an individual entitled to receive
1-10 health care services through a health care plan arranged for or
1-11 provided by the system.
1-12 (3) "Health care services" has the meaning assigned by
1-13 Section 2, Texas Health Maintenance Organization Act (Article
1-14 20A.02, Vernon's Texas Insurance Code).
1-15 (4) "Hospital provider" means a county hospital,
1-16 county hospital authority, hospital district, municipal hospital,
1-17 or municipal hospital authority.
1-18 (5) "Local health care provider" means:
1-19 (A) a person licensed, registered, or certified
1-20 as a health care practitioner in this state who resides in or
1-21 practices in a rural area in which the person provides health care
1-22 services; or
1-23 (B) a general or specialty hospital that is not
1-24 a hospital provider under this chapter.
2-1 (6) "Participating provider" means a hospital provider
2-2 that participates in the system.
2-3 (7) "Person" means an individual, professional
2-4 association, professional corporation, partnership, limited
2-5 liability corporation, limited liability partnership, or nonprofit
2-6 corporation, including a nonprofit corporation created under
2-7 Section 5.01(a), Medical Practice Act (Article 4495b, Vernon's
2-8 Texas Civil Statutes).
2-9 (8) "Rural area" means:
2-10 (A) a county with a population of 50,000 or
2-11 less;
2-12 (B) an area that is not delineated as an
2-13 urbanized area by the federal census bureau; or
2-14 (C) any other area designated as rural by rules
2-15 adopted by the commissioner, subject to Subsection (b) of this
2-16 article.
2-17 (9) "System" means the statewide rural health care
2-18 system established by this chapter.
2-19 (10) "Territorial jurisdiction" means the geographical
2-20 area in which a participating provider is obligated by law to
2-21 provide health care services.
2-22 (b) In designating rural areas under Subsection (a)(8) of
2-23 this article, the commissioner shall consider any area:
2-24 (1) in which appropriate emergency, acute, specialty,
2-25 or primary care services are limited or unavailable and could be
2-26 made more accessible through contracting with the system or a
2-27 participating community health network; or
3-1 (2) the demographics of which indicate a high
3-2 population of aged, at-risk, or low-income persons, including
3-3 persons with serious mental illness or serious emotional
3-4 disturbance, whose needs would be better served by allowing access
3-5 to care in a contiguous area that is eligible to participate in the
3-6 system.
3-7 SECTION 2. Article 20C.03, Insurance Code, is amended to
3-8 read as follows:
3-9 Art. 20C.03. ESTABLISHMENT OF SYSTEM. The statewide rural
3-10 health care system is established to arrange for or provide health
3-11 care services, including services on a prepaid basis, to enrollees
3-12 who reside in rural areas.
3-13 SECTION 3. Article 20C.04, Insurance Code, is amended to
3-14 read as follows:
3-15 Art. 20C.04. DESIGNATION AS SYSTEM; QUALIFICATIONS. (a)
3-16 The commissioner shall designate as the system one organization
3-17 created under Article 20C.05 of this code. Except as provided by
3-18 Subsection (b) of this article, to be eligible for designation as
3-19 the system, the organization must meet each requirement imposed by
3-20 the Texas Health Maintenance Organization Act (Chapter 20A,
3-21 Vernon's Texas Insurance Code), as if the organization were a
3-22 person under the Act.
3-23 (b) The commissioner by rule may provide exceptions to the
3-24 application of the Texas Health Maintenance Organization Act
3-25 (Chapter 20A, Vernon's Texas Insurance Code) to accommodate the
3-26 special circumstances surrounding the system and its participating
3-27 service areas designated as rural areas under this chapter.
4-1 (c) [(b)] The system shall meet all reserve requirements
4-2 required by the commissioner. The system may fulfill the
4-3 requirements of this subsection through the purchase of
4-4 reinsurance from insurance companies approved for that purpose by
4-5 the commissioner.
4-6 SECTION 4. Article 20C.07(a), Insurance Code, is amended to
4-7 read as follows:
4-8 (a) The members of the board serve staggered six-year terms,
4-9 with the terms of six members expiring December 1 of each
4-10 even-numbered year [February 1 of each odd-numbered year].
4-11 SECTION 5. Article 20C.08(f), Insurance Code, is amended to
4-12 read as follows:
4-13 (f) The board may [shall] appoint an advisory committee to
4-14 represent health care services, including representatives of rural,
4-15 urban, and educational groups and organizations. The advisory
4-16 committee shall meet at the will of the board and advise the board
4-17 on any matters as directed by the board [composed of:]
4-18 [(1) hospital administrators who represent nonprofit
4-19 and investor-owned facilities;]
4-20 [(2) representatives of hospital districts located in
4-21 urban areas;]
4-22 [(3) representatives of health care teaching
4-23 facilities;]
4-24 [(4) representatives of health care specialty
4-25 facilities;]
4-26 [(5) representatives of medical residency programs in
4-27 family practice; and]
5-1 [(6) representatives of rural health clinics,
5-2 federally qualified health centers, and ambulatory surgical
5-3 centers].
5-4 SECTION 6. (a) This Act takes effect September 1, 1999.
5-5 (b) The term of a member of the board of directors of the
5-6 statewide rural health care system appointed before the effective
5-7 date of this Act expires December 1 of the year before the year the
5-8 term was to expire under Chapter 20C, Insurance Code, as that
5-9 chapter existed before amendment by this Act.
5-10 SECTION 7. The importance of this legislation and the
5-11 crowded condition of the calendars in both houses create an
5-12 emergency and an imperative public necessity that the
5-13 constitutional rule requiring bills to be read on three several
5-14 days in each house be suspended, and this rule is hereby suspended.