SRC-CTC, MWN S.B. 544 77(R)   BILL ANALYSIS


Senate Research Center   S.B. 544
77R3069 AJA-DBy: Brown, J. E. "Buster"
Business & Commerce
2/27/2001
As Filed


DIGEST AND PURPOSE 

Currently, the requirement for health maintenance organizations (HMOs) to
cover health risk assessment screenings is found in the Administrative Code
but is not a statutory requirement.  As proposed, S.B. 544 mandates, by
statute, that HMOs include periodic health evaluations for each adult
enrollee in the basic health care services provided under certain coverage. 

RULEMAKING AUTHORITY

This bill does not expressly grant any additional rulemaking authority to a
state officer, institution, or agency. 

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Chapter 20A, Insurance Code, (The Texas Health
Maintenance Organization Act) by adding Section 9B, as follows: 

Sec. 9B. PERIODIC HEALTH EVALUATIONS REQUIRED. Requires the basic health
care services provided under an evidence of coverage to include periodic
health evaluations for each adult enrollee. Requires the services provided
under this section to include a health risk assessment at least once every
three years and, for a female enrollee, an annual well-woman examination
provided in accordance with Article 21.53D of this code, as added by
Chapter 912 (Access to Obstetrical or Gynecological Health Care), Acts of
the 75th Legislature, Regular Session, 1997. Provides that this section
does not apply to an evidence of coverage for limited health care service
plan or a single health care service plan. 

SECTION 2. Effective date: September 1, 2001. 
                      Makes application of this Act prospective to January
1, 2002.