By Smithee H.B. No. 3012
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the regulation of joint negotiations by physicians with
1-3 health benefit plans.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Article 29.06(b), Insurance Code, is amended to
1-6 read as follows:
1-7 (b) The department shall have the authority to collect and
1-8 investigate information necessary to determine, on a quarterly [an
1-9 annual] basis:
1-10 (1) the average number of covered lives per month per
1-11 county for each product type offered by every health care entity in
1-12 the state; and
1-13 (2) the annual impact, if any, of this article on
1-14 average physician fees in this state.
1-15 SECTION 2. Article 29.10, Insurance Code, is amended to read
1-16 as follows:
1-17 Art. 29.10. CERTAIN JOINT ACTION PROHIBITED. Nothing
1-18 contained in this chapter shall be construed to enable physicians
1-19 to jointly coordinate any cessation, reduction, or limitation of
1-20 health care services. [Physicians may not meet and communicate for
1-21 the purpose of jointly negotiating a requirement that a physician
1-22 or group of physicians, as a condition of the physicians' or group
1-23 of physicians' participation in a health benefit plan, must
1-24 participate in all the products within the same health benefit
2-1 plan.] Physicians may not negotiate with the plan to exclude,
2-2 limit, or otherwise restrict non-physician health care providers
2-3 from participation in a health benefit plan based substantially on
2-4 the fact the health care provider is not a licensed physician
2-5 unless that restriction, exclusion, or limitation is otherwise
2-6 permitted by law. The representative of the physicians shall
2-7 advise physicians of the provisions of this article and shall warn
2-8 physicians of the potential for legal action against physicians who
2-9 violate state or federal antitrust laws when acting outside the
2-10 authority of this chapter.
2-11 SECTION 3. Chapter 29, Insurance Code, is amended by adding
2-12 Article 29.10A to read as follows:
2-13 Art. 29.10A. CONFIDENTIALITY. (a) Detailed commercial or
2-14 financial information and internal operating or business
2-15 information about an individual physician or physician group
2-16 practice that is provided to the attorney general or the department
2-17 under this chapter is confidential and may not be made available
2-18 for examination or used by any person without the consent of the
2-19 person who produced the information. Information covered by this
2-20 article includes:
2-21 (1) physician fees;
2-22 (2) reimbursement rates; and
2-23 (3) income and revenue information.
2-24 (b) Final reports of approval or disapproval made by the
2-25 attorney general in accordance with Article 29.09(a) of this code
2-26 and final reports made by the department in accordance with Article
2-27 29.06(b) of this code are public.
3-1 SECTION 4. Article 29.14, Insurance Code, is amended to read
3-2 as follows:
3-3 Art. 29.14. EXPIRATION. This chapter expires September 1,
3-4 2005 [2003].
3-5 SECTION 5. This Act takes effect immediately if it receives
3-6 a vote of two-thirds of all the members elected to each house, as
3-7 provided by Section 39, Article III, Texas Constitution. If this
3-8 Act does not receive the vote necessary for immediate effect, this
3-9 Act takes effect September 1, 2001.