SRC-TBR S.B. 1571 77(R)   BILL ANALYSIS


Senate Research Center   S.B. 1571
By: Nelson
Business & Commerce
4/9/2001
As Filed


DIGEST AND PURPOSE 

Currently, most managed care plans require the same information, but each
plan places it in a different format and requires a physician to use the
plan's specific form.  As proposed, S.B. 1571 establishes the Health
Services Contract Panel to create standardized forms and contracts between
the plan and the provider. 

RULEMAKING AUTHORITY

Rulemaking authority is expressly granted to the Health Services Contract
Panel in SECTION 1 (Article 20D.05, Insurance Code) of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Title I, Insurance Code, by adding Chapter 20D, as
follows: 

Art. 20D.01.  Short Title.  Authorizes this Act to be cited as the Health
Services Contract Panel Act. 

Art. 20D.02.  Provides that the Health Services Contract Panel (panel) is
hereby created to draft and revise contract forms capable of
standardization for use by insurers, health maintenance organizations and
health plans regulated under this code when they contract with physicians
and health care providers.  Requires that contracts and revisions conform
to all applicable state laws and rules.  Requires the panel to establish
standardized contract addends, and guidelines for their use with the
adopted form contract.  Requires that any addenda not nullify or waive any
provision of the form contract. 

Art. 20D.03.  Provides that the panel established herein is
administratively attached to the Texas Department of Insurance.  Requires
the Texas Department of Insurance (department), at the request of the
panel, to provide administrative assistance to the panel; and the
department and the panel to coordinate administrative responsibilities in
order to avoid unnecessary duplication of facilities and services.
Requires the department at the request of the panel, to submit the panel's
budget request to the legislature.  Requires the panel to be subject,
except where inconsistent, to the rules and procedures of the department. 

Art. 20D.04.  (a)  Provides that the panel is composed of nine members,
selected by the Lieutenant governor and the speaker of the house. 

(b)  Requires the lieutenant governor and the speaker of the house to
select members according to certain criteria. 

(h)  Requires appointments to the panel to be made without regard to the
race, color, disability, sex, religion, age or national origin of the
appointee. 

  (i)(1)  Provides that members of the panel serve staggered six year terms.
 
(2)  Requires a vacancy occuring during a member's term, to be filled by
the Lieutenant governor and speaker of the house to appoint a person to
fill the vacancy. 

(c)  Provides that members of the panel are not entitled to compensation
for their services, but each panelist is entitled to reimbursement of any
necessary expense incurred in the performance of the members duties on the
panel including necessary travel expenses. 

(d)  Requires meetings of the panel to be held at the call of the chair or
on petition of at least three members of the panel. 

(e)  Requires that at the first meeting of the panel each year after its
members assume their positions, the panelists select one of the panel
members to serve as presiding chair and one of the panel members to service
as vice chair and each officer to serve for a term of one year.  Requires
the chair to preside at meetings of the panel, and the vice chair to
preside in the absence of the chair. 

(h)  Requires employees of the Texas Department of Insurance to serve as
staff for the panel. 

Art 20D.05.  (a)  Authorizes the panel, in the best interest of the public,
and in consultation with the commissioner of insurance, to adopt rules
requiring insurers, health maintenance organizations, and health plans to
use contract forms which have been adopted by the Health Services
Contracting Panel. 

(b)  Requires that not withstanding Subsection (a) of this article, the
panel not prohibit a physician or health care provider from using a
contract form or forms which have been prepared by an attorney for the
physician or health care provider and which are required by physician or
the health care provider. 

Art. 20D.06.  Prohibits an insurer, health maintenance organization, or a
health plan from taking certain actions. 

Art. 20D.07.  (a)  Provides that a violation of a provision of this chapter
by an insurer, health maintenance organization or a health plan is a
violation of Articles 21.21 and 21.21A with such remedies as are available
under such articles. 

(b)  Authorizes the commissioner of insurance to suspend or revoke a
license or authority to engage in the business of insurance under this
code, when the commissioner has determined that the insurer, health
maintenance organization, or health care plan failed to use a contract form
as required by the panel pursuant to this chapter. 

(c)  Provides that the provisions of this article are cumulative of any
other remedies available by law or rule. 

SECTION 2.  Requires that not later than January 1, 2002, the panel adopt
rules required by this chapter. 

SECTION 3.  Requires an insurer, health maintenance organization, or health
plan to use the standard form contract for any contract signed or renewed
on or after September 1, 2002. 

SECTION 4.  Effective date: upon passage or September 1, 2001.