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


Senate Research CenterC.S.S.B. 494
78R8523 DLF-DBy: Shapleigh
State Affairs
3/12/2003
Committee Report (Substituted)


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.  C.S.S.B. 494 requires insurers,
group hospital service corporations, and health maintenance organizations
that maintain an Internet site to list on that site those physicians and
providers that may be used by insureds or 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 (Section 6A, Article 3.70-3C, Insurance Code), SECTION 2
(Section 842.261, Insurance Code), and SECTION 3 (Section  843.2015,
Insurance Code) of this bill.   

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Article 3.70-3C, Insurance Code, by adding Section 6A,
as follows: 

Sec.  6A.  INFORMATION AVAILABLE THROUGH INTERNET SITE. (a)  Requires an
insurer subject to this article that maintains an Internet site to list on
that site preferred providers, including mental health and substance abuse
providers, that may be used by insureds in accordance with the terms of
the insured's preferred provider benefit plan.  Requires the listing to
identify those physicians and providers who continue to be available to
provide services to new patients or clients. 

(b)  Requires an insurer to update the Internet site subject to this
section at least quarterly. 

(c)  Authorizes the commissioner of insurance (commissioner) to adopt
rules necessary to implement this article, including rules that govern the
form and content of the information required under Subsection (a). 

(d)  Provides that this section applies to an entity subject to Chapter
941 or 942 and to an arrangement that holds a certificate under Chapter
846, notwithstanding any other provision of this article. 

SECTION 2.  Amends Chapter 842F, Insurance Code, by adding Section
842.261, as follows: 

Sec. 842.261.  INFORMATION AVAILABLE THROUGH INTERNET SITE. (a) Requires a
group hospital service corporation that maintains an Internet site to list
on that site preferred providers, including mental health and substance
abuse providers, that may be used by members in accordance with the terms
of the policy or certificate applicable to the member.  Requires the
listing to identify those physicians and providers who continue to be
available to provide services to new patients or clients. 

(b)  Requires the group hospital service corporation to update the
Internet site subject to this section at least quarterly. 

(c)  Authorizes the commissioner to adopt rules necessary to implement
this article, including rules that govern the form and content of the
information required under Subsection (a). 

SECTION 3.  Amends Chapter 843F, Insurance Code, by adding Section
843.2015, as follows: 

Sec.  843.2015.  INFORMATION AVAILABLE THROUGH INTERNET SITE. (a) Requires
a health maintenance organization that maintains an Internet site to list
on that site preferred providers, including mental health and substance
abuse providers, that may be used by enrollees in accordance with the
terms of the insured's preferred provider benefit plan. Requires the
listing to identify those physicians and providers who continue to be
available to provide services to new patients or clients. 

(b)  Requires the health maintenance organization to update the Internet
site subject to this section at least quarterly. 

(c)  Authorizes the commissioner of insurance to adopt rules necessary to
implement this article, including rules that govern the form and content
of the information required under Subsection (a). 

SECTION 4.  Provides that an insurer, group hospital service corporation,
or health maintenance organization is not required to comply with the
change in law made by this Act before January 1, 2004. 

SECTION 5.  Effective date:  September 1, 2003.

SUMMARY OF COMMITTEE CHANGES

In SECTION 1:  Replaces SECTION 1 in original with a new section
applicable specifically to certain insurers. 

In SECTION 2:  Replaces SECTION 2 in original with a new section
applicable specifically to certain group hospital service corporations. 

In SECTION 3:  Replaces SECTION 3 in original with a new section
applicable specifically to certain health maintenance organizations. 

In SECTION 4:  Redesignated from SECTION 3 in original and reworded to
apply specifically to an insurer, group hospital service corporation, or
health maintenance organization affected by this Act. 

In SECTION 5:  Redesignated from SECTION 2 in original.