77R10974 PB-F                           
         By Smithee                                            H.B. No. 3012
         Substitute the following for H.B. No. 3012:
         By Smithee                                        C.S.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.  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           SECTION 4. Article 29.14, Insurance Code, is amended to read
2-25     as follows:
2-26           Art. 29.14. EXPIRATION. This chapter expires September 1,
2-27     2005 [2003].
 3-1           SECTION 5.  This Act takes effect immediately if it receives
 3-2     a vote of two-thirds of all the members elected to each house, as
 3-3     provided by Section 39, Article III, Texas Constitution.  If this
 3-4     Act does not receive the vote necessary for immediate effect, this
 3-5     Act takes effect September 1, 2001.