1-1     By:  Sibley                                           S.B. No. 1884
 1-2           (In the Senate - Filed April 23, 1999; April 23, 1999, read
 1-3     first time and referred to Committee on Economic Development;
 1-4     April 27, 1999, reported adversely, with favorable Committee
 1-5     Substitute by the following vote:  Yeas 4, Nays 0; April 27, 1999,
 1-6     sent to printer.)
 1-7     COMMITTEE SUBSTITUTE FOR S.B. No. 1884                  By:  Sibley
 1-8                            A BILL TO BE ENTITLED
 1-9                                   AN ACT
1-10     relating to independent review of certain health insurance claims.
1-11           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-12           SECTION 1.  Section 88.003, Civil Practice and Remedies Code,
1-13     as added by Chapter 163, Acts of the 75th Legislature, Regular
1-14     Session, 1997, is amended to read as follows:
1-15           Sec. 88.003.  Limitations on Cause of Action.  (a)  A person
1-16     may not maintain a cause of action under this chapter against a
1-17     health insurance carrier, health maintenance organization, or other
1-18     managed care entity that is required to comply with or otherwise
1-19     complies with the utilization review requirements of Article
1-20     21.58A, Insurance Code, or the Texas Health Maintenance
1-21     Organization Act (Chapter 20A, Vernon's Texas Insurance Code),
1-22     unless the affected insured or enrollee or the insured's or
1-23     enrollee's representative:
1-24                 (1)  has exhausted the appeals and review applicable
1-25     under the utilization review requirements; or
1-26                 (2)  before instituting the action:
1-27                       (A)  gives written notice of the claim as
1-28     provided by Subsection (b); and
1-29                       (B)  agrees to submit the claim to a review by an
1-30     independent review organization under Article 21.58A, Insurance
1-31     Code, as required by Subsections [Subsection] (c) and (d).
1-32           (b)  The notice required by Subsection (a)(2)(A) must be
1-33     delivered or mailed to the health insurance carrier, health
1-34     maintenance organization, or managed care entity against whom the
1-35     action is made not later than the 30th day before the date the
1-36     claim is filed.
1-37           (c)  The insured or enrollee or the insured's or enrollee's
1-38     representative must submit the claim to a review by an independent
1-39     review organization if the health insurance carrier, health
1-40     maintenance organization, or managed care entity against whom the
1-41     claim is made requests the review not later than the 14th day after
1-42     the date notice under Subsection (a)(2)(A) is received by the
1-43     health insurance carrier, health maintenance organization, or
1-44     managed care entity.  If the health insurance carrier, health
1-45     maintenance organization, or managed care entity does not request
1-46     the review within the period specified by this subsection, the
1-47     insured or enrollee or the insured's or enrollee's representative
1-48     is not required to submit the claim to independent review before
1-49     maintaining the action.
1-50           (d)  A review conducted under Subsection (c) as requested by
1-51     a health insurance carrier, health maintenance organization, or
1-52     managed care entity must be performed in accordance with Article
1-53     21.58C, Insurance Code.  The health insurance carrier, health
1-54     maintenance organization, or managed care entity requesting the
1-55     review must agree to comply with Subdivisions (2), (3), and (4),
1-56     Section 6A, Article 21.58A, Insurance Code.
1-57           (e)  Subject to Subsection (f) [(e)], if the enrollee has not
1-58     complied with Subsection (a), an action under this section shall
1-59     not be dismissed by the court, but the court may, in its
1-60     discretion, order the parties to submit to an independent review or
1-61     mediation or other nonbinding alternative dispute resolution and
1-62     may abate the action for a period of not to exceed 30 days for such
1-63     purposes.  Such orders of the court shall be the sole remedy
1-64     available to a party complaining of an enrollee's failure to comply
 2-1     with Subsection (a).
 2-2           (f) [(e)]  The enrollee is not required to comply with
 2-3     Subsection (c) and no abatement or other order pursuant to
 2-4     Subsection (e) [(d)] for failure to comply shall be imposed if the
 2-5     enrollee has filed a pleading alleging in substance that:
 2-6                 (1)  harm to the enrollee has already occurred because
 2-7     of the conduct of the health insurance carrier, health maintenance
 2-8     organization, or managed care entity or because of an act or
 2-9     omission of an employee, agent, ostensible agent, or representative
2-10     of such carrier, organization, or entity for whose conduct it is
2-11     liable under Section 88.002(b); and
2-12                 (2)  the review would not be beneficial to the
2-13     enrollee, unless the court, upon motion by a defendant carrier,
2-14     organization, or entity finds after hearing that such pleading was
2-15     not made in good faith, in which case the court may enter an order
2-16     pursuant to Subsection (e) [(d)].
2-17           (g) [(f)]  If the insured or enrollee or the insured's or
2-18     enrollee's representative seeks to exhaust the appeals and review
2-19     or provides notice, as required by Subsection (a), before the
2-20     statute of limitations applicable to a claim against a managed care
2-21     entity has expired, the limitations period is tolled until the
2-22     later of:
2-23                 (1)  the 30th day after the date the insured or
2-24     enrollee or the insured's or enrollee's representative has
2-25     exhausted the process for appeals and review applicable under the
2-26     utilization review requirements; or
2-27                 (2)  the 40th day after the date the insured or
2-28     enrollee or the insured's or enrollee's representative gives notice
2-29     under Subsection (a)(2)(A).
2-30           (h) [(g)]  This section does not prohibit an insured or
2-31     enrollee from pursuing other appropriate remedies, including
2-32     injunctive relief, a declaratory judgment, or relief available
2-33     under law, if the requirement of exhausting the process for appeal
2-34     and review places the insured's or enrollee's health in serious
2-35     jeopardy.
2-36           SECTION 2.  This Act takes effect September 1, 1999.
2-37           SECTION 3.  This Act applies only to a cause of action that
2-38     accrues on or after the effective date of this Act.  A cause of
2-39     action that accrues before the effective date of this Act is
2-40     governed by the law as it existed immediately before the effective
2-41     date of this Act and that law is continued in effect for this
2-42     purpose.
2-43           SECTION 4.  The importance of this legislation and the
2-44     crowded condition of the calendars in both houses create an
2-45     emergency and an imperative public necessity that the
2-46     constitutional rule requiring bills to be read on three several
2-47     days in each house be suspended, and this rule is hereby suspended.
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