78R11438 AKH-D


By:  Thompson                                                     H.B. No. 1163



A BILL TO BE ENTITLED

AN ACT

relating to contracts between certain health care providers and 
health benefit plans.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Section 3(b), Article 3.70-3C, Insurance Code, 
as added by Chapter 1024, Acts of the 75th Legislature, Regular 
Session, 1997, is amended by adding Subdivision (5) to read as 
follows:
		(5)  An insurer may not withhold a designation to a 
podiatrist described by Subsection (p) of this section.
	SECTION 2.  Section 3, Article 3.70-3C, Insurance Code, as 
added by Chapter 1024, Acts of the 75th Legislature, Regular 
Session, 1997, is amended by adding Subsection (p) to read as 
follows:
	(p)  An insurer may not withhold the designation of preferred 
provider to a podiatrist licensed by the Texas State Board of 
Podiatric Medical Examiners who joins the professional practice of 
a contracted preferred provider, applies to the insurer for 
designation as a preferred provider, and complies with the terms 
and conditions of eligibility to be a preferred provider.  A 
podiatrist designated as a preferred provider under this subsection 
must comply with the terms of the preferred provider contract used 
by the insurer or the insurer's network provider.
	SECTION 3.  Section 843.303, Insurance Code, as effective 
June 1, 2003, is amended by adding Subsection (c) to read as 
follows:
	(c)  A health maintenance organization may not deny a 
contract to a podiatrist described by Section 843.319.
	SECTION 4.  Subchapter I, Chapter 843, Insurance Code, as 
effective June 1, 2003, is amended by adding Section 843.319 to read 
as follows:
	Sec. 843.319.  CERTAIN REQUIRED CONTRACTS.  A health 
maintenance organization may not deny a contract to a podiatrist 
licensed by the Texas State Board of Podiatric Medical Examiners 
who joins the professional practice of a contracting physician or 
provider, satisfies the application procedures of the health 
maintenance organization, and meets the qualification and 
credentialing requirements for contracting with the health 
maintenance organization.
	SECTION 5.  Section 3(p), Article 3.70-3C, and Section 
843.319, Insurance Code, as added by this Act, apply only to an 
application for designation as a preferred provider or an 
application to contract with a health maintenance organization 
submitted to an insurer or health maintenance organization on or 
after September 1, 2003. An application submitted before that date 
is governed by the law as it existed immediately before the 
effective date of this Act, and that law is continued in effect for 
that purpose.
	SECTION 6.  This Act takes effect September 1, 2003.