SRC-MSY S.B. 494 78(R)   BILL ANALYSIS


Senate Research Center   S.B. 494
78R638 DLF-DBy: Shapleigh
State Affairs
2/24/2003
As Filed


DIGEST AND PURPOSE 

Under current law, health maintenance organizations are required to update
their list of health care providers on a quarterly basis, but are not
required to indicate these updates on their Internet site. Preferred
provider organizations are required to update their lists on an annual
basis.  In addition, these updates do not indicate which providers are
accepting new patients and which are not.  As proposed, S.B. 494  requires
a wide range of insurance providers to maintain an Internet site listing
physicians and providers that may be used by plan enrollees, and to
indicate which providers are accepting new patients.  Furthermore, the
bill requires that the site be updated at least quarterly. 

RULEMAKING AUTHORITY

Rulemaking authority is expressly granted to the commissioner of insurance
in SECTION 1 (Art. 21.71A) of this bill.   

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Chapter 21E, Insurance Code, by adding Article 21.71A,
as follows: 

Art.  21.71A.  HEALTH BENEFIT PLAN INTERNET SITE.  (a)  Provides that this
article applies to a health maintenance organization and an insurer, a
group hospital service corporation, a fraternal benefit society, a
stipulated premium insurer, a reciprocal or interinsurance exchange, a
multiple employer welfare arrangement under Chapter 846, and an approved
nonprofit health corporation that offers certain plans. 

(b)  Requires an entity subject to this article to maintain an Internet
site listing physicians and providers, including mental health and
substance abuse providers, that may be used by enrollees in accordance
with the terms of the plan in which the enrollee is enrolled. Requires the
listing to identify those physicians and providers who continue to be
available to provide services to new patients or clients. 

(c)  Requires an entity subject to this article to update the Internet
site required by this article at least quarterly. 

(d)  Authorizes the commissioner of insurance to adopt rules necessary to
implement this article, including rules that govern the form and content
of the Internet site required by this article. 

SECTION 2.  Effective date:  September 1, 2003.

SECTION 3.  Makes application of this act prospective to January 1, 2004.