SRC-LBB S.B. 857 78(R)BILL ANALYSIS


Senate Research CenterS.B. 857
By: Madla
State Affairs
8/7/2003
Enrolled


DIGEST AND PURPOSE 

Currently, many managed care plans have two panels of doctors.  One panel
provides routine eye exams and the other panel handles medical problems,
including medical eye problems.  However, many medical eye problems can be
treated by a therapeutic optometrist.  If a patient with a medical eye
condition goes to an eye doctor on the vision panel, unless the doctor is
also on the medical panel, the doctor must refer the patient to a doctor
who is on the medical panel for treatment.  This requires the patient to
go for a second office visit to a new doctor to begin treatment or pay for
services.  S.B. 857 allows a therapeutic optometrist who is on a managed
care vision plan to join the managed care medical plan if the optometrist
abides by certain conditions and provisions. 

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 21.52D, Insurance Code, by amending Subsection
(a) and adding Subsections (d), (e), and (f), as follows: 

(a)  Defines "medical panel" and "vision panel" and creates Subdivision
(3) from existing text. 

(d)  Requires a managed care plan that provides or arranges for vision or
medical eye care services or procedures to allow a therapeutic optometrist
who is on one or more of the vision panels of the plan to be a fully
participating provider on the plan's medical panels to the full extent of
the optometrist's license to practice therapeutic optometry. 

(e)  Requires a therapeutic optometrist who is included in a managed care
plan's medical panels under Subsection (d) to satisfy certain terms and
conditions. 

(f)  Authorizes a managed care plan that provides or arranges for vision
or medical eye care services or procedures to charge a participating
therapeutic optometrist certain fees. 

SECTION 2.  (a)  Effective date:  September 1, 2003.

(b)  Makes application of this Act prospective to January 1, 2004, in
relation to a managed care policy, contract, or evidence of coverage. 

(c)  Makes application of this act prospective in relation to a contract
between a managed care plan and a therapeutic optometrist.