SRC-MSY S.B. 382 78(R)   BILL ANALYSIS


Senate Research Center   S.B. 382
78R3144 PB-FBy: Armbrister
State Affairs
3/19/2003
As Filed


DIGEST AND PURPOSE 

Current Texas law does not include licensed athletic trainers as
practitioners who insurance policy provisions must recognize or not
recognize for purposes of direct reimbursement of services.  As proposed,
S.B. 382 amends the Insurance Code to make licensed athletic trainers
eligible for direct reimbursement from insurance providers in the same
manner as currently provided to other health care practitioners. 

RULEMAKING AUTHORITY

This bill does not expressly grant any additional rulemaking authority to
a state officer, institution, or agency. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Article.3.70-2, Insurance Code, by adding a Licensed
Athletic Trainer as a practitioner who may or may not be explicitly
recognized by an insurer for purposes of providing benefits under a policy
of accident and sickness insurance.  Defines "Licensed Athletic Trainer
for the purposes of this Act.  Makes nonsubstantive changes. 

SECTION 2.  Amends Article 3.70-3C, Insurance Code, by adding Subsection
(p), to prohibit a preferred provider from refusing to contract with an
athletic trainer, as defined under Section 451.001, Occupations Code, to
be included in the provider's network or refusing to reimburse the
athletic trainer for a covered service that a physician has requested the
athletic trainer to perform. 

SECTION 3.  Amends Section 1, Article 21.52, Insurance Code, by adding
Subsection (w) to define "licensed athletic trainer."  Makes a
nonsubstantive change. 

SECTION 4.  Amends Section 3(a), Article 21.52, Insurance Code, by
creating Subdivisions (18) and (19) from existing Subdivisions (17) and
(18), and by adding Subdivision (20), as follows: 

(20)  Adds a license athletic trainer to the list of professionals that a
beneficiary of a health insurance policy in this state may select to
provide relevant services if such services are scheduled in the policy.  

SECTION 5.  Amends Section 3(c), Article 21.52, Insurance Code, to add a
licensed athletic trainer to the list of professionals for whose services
an insurance company, association, or organization may not deny payment or
reimbursement, if such services are carried out in accordance with the
payment schedule or provisions. 

SECTION 6.  Amends Section 3(d), Article 21.52, Insurance Code, to add a
licensed athletic trainer to the list of professionals between which there
may be no differentiation or discrimination in the payment schedule or
provisions in a health insurance policy nor in the amount or manner of
payment for services or procedures. 

 SECTION 7.  Amends Chapter 843I, Insurance Code, by adding Section
843.3121, as follows: 

Sec.  843.3121.  ATHLETIC TRAINERS.  Prohibits a health maintenance
organization from refusing to contract with an athletic trainer, as
defined by Section 451.001, Occupations Code, to be included in the
organization's provider network or refusing to reimburse the athletic
trainer for a covered service that a physician has requested the athletic
trainer to perform. 

SECTION 8.  Effective date:  September1, 2003.
Makes application of this Act prospective to January 1, 2004.