77R12265 MXM-F                           
         By Goodman                                            H.B. No. 2620
         Substitute the following for H.B. No. 2620:
         By Eiland                                         C.S.H.B. No. 2620
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to standardizing physician contracts and forms used in
 1-3     managed care plans.
 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-5           SECTION 1.  Subchapter E, Chapter 21, Insurance Code, is
 1-6     amended by adding Article 21.52K to read as follows:
 1-7           Art. 21.52K.  STANDARD MANAGED CARE CONTRACTS FOR PHYSICIANS
 1-8           Sec. 1.  DEFINITIONS.  In this article:
 1-9                 (1)  "Managed care entity" means an entity described by
1-10     Section 2 of this article.
1-11                 (2)  "Managed care plan" means a health benefit plan:
1-12                       (A)  under which health care services are
1-13     provided to enrollees through contracts with health care
1-14     professionals  or health care facilities; and
1-15                       (B)  that provides financial incentives to
1-16     enrollees in the plan to use the participating practitioners,
1-17     participating health care facilities, and procedures covered by the
1-18     plan.
1-19           Sec. 2.  SCOPE OF ARTICLE.  This article applies to a health
1-20     maintenance organization, a preferred provider organization, an
1-21     approved nonprofit health corporation that holds a certificate of
1-22     authority  issued by the commissioner under Article 21.52F of this
1-23     code, and any other entity that offers a managed care plan,
1-24     including:
 2-1                 (1)  an insurance company;
 2-2                 (2)  a group hospital service corporation operating
 2-3     under Chapter 20 of this code;
 2-4                 (3)  a fraternal benefit society operating under
 2-5     Chapter 10 of this code; or
 2-6                 (4)  a stipulated premium insurance company operating
 2-7     under Chapter 22 of this code.
 2-8           Sec. 3.  RULES REGARDING STANDARD PHYSICIAN CONTRACTS. The
 2-9     commissioner shall adopt rules that establish, and require managed
2-10     care entities to use, standard physician contracts and forms for
2-11     those contracts.
2-12           SECTION 2. (a)  This Act takes effect September 1, 2001.
2-13           (b)  Not later than January 1, 2002, the commissioner of
2-14     insurance shall adopt the rules, contracts, and forms required by
2-15     Section 3, Article 21.52K, Insurance Code, as added by this Act.