By Capelo                                             H.B. No. 1913
         77R6878 DLF-F                           
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to termination of certain contracts by a preferred
 1-3     provider organization or health maintenance organization.
 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-5           SECTION 1. Section 3, Article 3.70-3C, Insurance Code, as
 1-6     added by Chapter 1024, Acts of the 75th Legislature, Regular
 1-7     Session, 1997, is amended by amending Subsection (g) and adding
 1-8     Subsections (o) and (p) to read as follows:
 1-9           (g)  Before terminating a contract with a preferred provider,
1-10     the insurer shall provide written reasons for the termination.  On
1-11     request and, except as provided by this subsection, prior [Prior]
1-12     to termination of a physician or practitioner, but within a period
1-13     not to exceed 60 days, the insurer shall[, on request,] provide a
1-14     reasonable review mechanism that incorporates, in an advisory role
1-15     [only], a review panel selected in the manner described in
1-16     Subsection (b)(3) of this section, under a peer review process that
1-17     meets the requirements of 42 U.S.C. Section 11101 et seq., as
1-18     amended. In [except in] cases in which there is imminent harm to a
1-19     patient's health or an action by a state medical or other physician
1-20     licensing board or other government agency that effectively impairs
1-21     a physician's or practitioner's ability to practice medicine or in
1-22     cases of fraud or malfeasance, the peer review process must be
1-23     initiated simultaneously with the termination or suspension.  Any
1-24     recommendation of the panel shall be provided to the affected
 2-1     physician or practitioner.  An [In the event of an] insurer
 2-2     determination contrary to any recommendation of the panel must be
 2-3     for good cause shown, and a written explanation of the insurer's
 2-4     determination shall also be provided [on request] to the affected
 2-5     physician or practitioner.  On request, an expedited review process
 2-6     shall be made available to a physician or practitioner who is being
 2-7     terminated.  The expedited review process shall comply with rules
 2-8     established by the commissioner.
 2-9           (o)  A preferred provider who is injured by an insurer's
2-10     failure to follow the due process procedures required under
2-11     Subsection (g) of this section may bring an action against the
2-12     insurer to recover:
2-13                 (1)  the damages incurred;
2-14                 (2)  court costs and attorney's fees reasonable in
2-15     relation to the amount of work expended;
2-16                 (3)  an order enjoining the act or failure to act; and
2-17                 (4)  other relief the court considers proper.
2-18           (p)  A preferred provider may bring an action under
2-19     Subsection (o) of this section on the person's own behalf and on
2-20     behalf of others similarly situated.
2-21           SECTION 2. Section 18A, Texas Health Maintenance Organization
2-22     Act (Chapter 20A, Vernon's Texas Insurance Code), as added by
2-23     Chapter 1026, Acts of the 75th Legislature, Regular Session, 1997,
2-24     is amended by amending Subsection (b) and adding Subsections (k)
2-25     and (l) to read as follows:
2-26           (b)  Before terminating a contract with a physician or
2-27     provider, the health maintenance organization shall provide a
 3-1     written explanation to the physician or provider of the reasons for
 3-2     termination.  On request and, except as provided by this
 3-3     subsection, before the effective date of the termination, but
 3-4     within a period not to exceed 60 days, a physician or provider
 3-5     shall be entitled to a review of the health maintenance
 3-6     organization's proposed termination by an advisory review panel,
 3-7     under a peer review process that meets the requirements of 42
 3-8     U.S.C. Section 11101 et seq., as amended. In [except in] a case in
 3-9     which there is imminent harm to patient health or an action by a
3-10     state medical or dental board, other medical or dental licensing
3-11     board, or other licensing board or other government agency, that
3-12     effectively impairs the physician's or provider's ability to
3-13     practice medicine, dentistry, or another profession, or in a case
3-14     of fraud or malfeasance, the peer review process must be initiated
3-15     simultaneously with the termination or suspension.  The advisory
3-16     review panel shall be composed of physicians and providers,
3-17     including at least one representative in the physician's or
3-18     provider's specialty or a similar specialty, if available,
3-19     appointed to serve on the standing quality assurance committee or
3-20     utilization review committee of the health maintenance
3-21     organization.  The decision of the advisory review panel must be
3-22     considered and [but] is [not] binding on the health maintenance
3-23     organization, except for good cause shown.  The health maintenance
3-24     organization shall provide to the affected physician or provider,
3-25     on request, a copy of the recommendation of the advisory review
3-26     panel and the health maintenance organization's determination.
3-27           (k)  A physician or provider who is injured by a health
 4-1     maintenance organization's failure to follow the due process
 4-2     procedures required under Subsection (b) of this section may bring
 4-3     an action against the health maintenance organization to recover:
 4-4                 (1)  the damages incurred;
 4-5                 (2)  court costs and attorney's fees reasonable in
 4-6     relation to the amount of work expended;
 4-7                 (3)  an order enjoining the act or failure to act; and
 4-8                 (4)  other relief the court considers proper.
 4-9           (l)  A physician or provider may bring an action under
4-10     Subsection (k) of this section on the person's own behalf and on
4-11     behalf of others similarly situated.
4-12           SECTION 3. This Act applies only to a contract between an
4-13     insurer and a preferred provider or a health maintenance
4-14     organization and a physician or provider that is entered into or
4-15     renewed on or after the effective date of this Act.  A contract
4-16     that is entered into or renewed before the effective date of this
4-17     Act is governed by the law in effect immediately before the
4-18     effective date of this Act, and that law is continued in effect for
4-19     that purpose.
4-20           SECTION 4.  This Act takes effect immediately if it receives
4-21     a vote of two-thirds of all the members elected to each house, as
4-22     provided by Section 39, Article III, Texas Constitution.  If this
4-23     Act does not receive the vote necessary for immediate effect, this
4-24     Act takes effect September 1, 2001.