1-1                                   AN ACT
 1-2     relating to requiring the provision of periodic health evaluations
 1-3     and credentialing of physicians and health care providers by health
 1-4     maintenance organizations and to the verification of physician
 1-5     credentials.
 1-6           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-7           SECTION 1.  The Texas Health Maintenance Organization Act
 1-8     (Chapter 20A, Vernon's Texas Insurance Code) is amended by adding
 1-9     Section 9B to read as follows:
1-10           Sec. 9B.  PERIODIC HEALTH EVALUATIONS REQUIRED.  (a)  The
1-11     basic health care services provided under an evidence of coverage
1-12     must include periodic health evaluations for each adult enrollee.
1-13           (b)  The services provided under this section must include a
1-14     health risk assessment at least once every three years and, for a
1-15     female enrollee, an annual well-woman examination provided in
1-16     accordance with Article 21.53D of this code, as added by Chapter
1-17     912, Acts of the 75th Legislature, Regular Session, 1997.
1-18           (c)  This section does not apply to an evidence of coverage
1-19     for a limited health care service plan or a single health care
1-20     service plan.
1-21           SECTION 2.  The Texas Health Maintenance Organization Act
1-22     (Chapter 20A, Vernon's Texas Insurance Code) is amended by adding
1-23     Section 39 to read as follows:
1-24           Sec. 39.  CREDENTIALING OF PHYSICIANS AND PROVIDERS.
1-25     (a)  Rules adopted by the commissioner under Section 37 of this Act
 2-1     that relate to implementation and maintenance by a health
 2-2     maintenance organization of a process for selecting and retaining
 2-3     affiliated physicians and providers must comply with:
 2-4                 (1)  this section; and
 2-5                 (2)  standards promulgated by the National Committee
 2-6     for Quality Assurance, to the extent those standards do not
 2-7     conflict with other laws of this state.
 2-8           (b)  The commissioner shall require a health maintenance
 2-9     organization to verify that a physician's license to practice
2-10     medicine and any other certificate the physician is required to
2-11     hold, including a certificate issued by the Department of Public
2-12     Safety of the State of Texas or the federal Drug Enforcement Agency
2-13     or a certificate issued under the Medicare program, is valid as of
2-14     the date of initial credentialing and on the date of each
2-15     recredentialing.
2-16           (c)  The commissioner shall require a health maintenance
2-17     organization that conducts a site visit for the purpose of initial
2-18     credentialing to evaluate during the visit a site's accessibility,
2-19     appearance, space, medical or dental recordkeeping practices,
2-20     availability of appointments, and confidentiality procedures.  The
2-21     commissioner may not require the health maintenance organization to
2-22     evaluate the appropriateness of equipment during the site visit.
2-23           (d)  The commissioner may not require that a health
2-24     maintenance organization:
2-25                 (1)  formally recredential physicians or providers more
2-26     frequently than once in any three-year period;
 3-1                 (2)  verify the validity of a license or certificate
 3-2     held by a physician other than as of the date of initial
 3-3     credentialing or recredentialing of the physician;
 3-4                 (3)  use clinical personnel to perform a site visit for
 3-5     initial credentialing of a physician or provider unless clinical
 3-6     review is needed during the site visit; or
 3-7                 (4)  require a site visit be performed for
 3-8     recredentialing of a physician or provider.
 3-9           (e)  This section does not preclude a health maintenance
3-10     organization from performing a site visit of a physician or
3-11     provider at any time for cause, including a complaint made by a
3-12     member or another external complaint made to the health maintenance
3-13     organization.
3-14           SECTION 3.  Subchapter E, Chapter 21, Insurance Code, is
3-15     amended by adding Article 21.58D to read as follows:
3-16           Art. 21.58D.  STANDARDIZED FORM FOR VERIFICATION OF PHYSICIAN
3-17     CREDENTIALS
3-18           Sec. 1.  DEFINITION.  In this article, "physician" means an
3-19     individual licensed to practice medicine in this state.
3-20           Sec. 2.  STANDARDIZED FORM.  (a)  The commissioner by rule
3-21     shall:
3-22                 (1)  adopt a standardized form for the verification of
3-23     the credentials of a physician; and
3-24                 (2)  require that a public or private hospital, a
3-25     health maintenance organization operating under the Texas Health
3-26     Maintenance Organization Act (Chapter 20A, Vernon's Texas Insurance
 4-1     Code), or a preferred provider organization operating under Article
 4-2     3.70-3C, Insurance Code, as added by Chapter 1024, Acts of the 75th
 4-3     Legislature, Regular Session, 1997, use the form for verification
 4-4     of credentials.
 4-5           (b)  In adopting a form under Subsection (a) of this section,
 4-6     the commissioner shall consider any credentialing application form
 4-7     that is widely used in this state.
 4-8           SECTION 4.  (a)  The Texas State Board of Medical Examiners
 4-9     shall study the establishment of a program for standardized
4-10     credentials verification through using a credentialing information
4-11     system.
4-12           (b)  Not later than January 1, 2003, the Texas State Board of
4-13     Medical Examiners shall report on its recommendations for proposed
4-14     legislation, based on the study conducted under Subsection (a) of
4-15     this section, to:
4-16                 (1)  the governor;
4-17                 (2)  the lieutenant governor; and
4-18                 (3)  the speaker of the house of representatives.
4-19           SECTION 5.  Sections 2, 3, and 4 of this Act take effect
4-20     September 1, 2001.  Section 1 of this Act takes effect September 1,
4-21     2001, and applies only to an evidence of coverage that is
4-22     delivered, issued for delivery, or renewed on or after January 1,
4-23     2002.  An evidence of coverage that is delivered, issued for
4-24     delivery, or renewed before January 1, 2002, is governed by the law
4-25     as it existed immediately before the effective date of this Act,
4-26     and that law is continued in effect for that purpose.
         _______________________________     _______________________________
             President of the Senate              Speaker of the House
               I hereby certify that S.B. No. 544 passed the Senate on
         April 5, 2001, by the following vote:  Yeas 30, Nays 0, one present
         not voting; and that the Senate concurred in House amendment on
         May 26, 2001, by a viva-voce vote.
                                             _______________________________
                                                 Secretary of the Senate
               I hereby certify that S.B. No. 544 passed the House, with
         amendment, on May 23, 2001, by a non-record vote.
                                             _______________________________
                                                Chief Clerk of the House
         Approved:
         _______________________________
                      Date
         _______________________________
                    Governor