78R9526 DLF-F


By:  Taylor, Madden, Wohlgemuth                                   H.B. No. 3023



A BILL TO BE ENTITLED

AN ACT

relating to reimbursement and use of particular health care 
practitioners.  
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Section 3(d), Article 21.52, Insurance Code, as 
amended by Chapters 812 and 1014, Acts of the 77th Legislature, 
Regular Session, 2001, is amended to read as follows:
	(d)  There shall not be any classification, differentiation, 
or other discrimination in the payment schedule or the payment 
provisions in a health insurance policy, nor in the amount or manner 
of payment or reimbursement thereunder, between scheduled services 
or procedures when performed by a doctor of podiatric medicine, a 
doctor of optometry, a doctor of chiropractic, a licensed dentist, 
an occupational therapist, a physical therapist, a licensed 
audiologist, a licensed speech-language pathologist, a licensed 
master social worker--advanced clinical practitioner, a licensed 
dietitian, a licensed professional counselor, a licensed marriage 
and family therapist, a psychologist, a licensed psychological 
associate, a licensed chemical dependency counselor, an advanced 
practice nurse to provide the services scheduled in the policy, a 
nurse first assistant to provide the services scheduled in the 
policy and requested by the physician whom the nurse is assisting, a 
physician assistant to provide the services scheduled in the 
policy, a licensed acupuncturist, or a licensed hearing instrument 
fitter and dispenser which fall within the scope of that 
practitioner's license or certification and the same services or 
procedures when performed by any other practitioner of the healing 
arts whose services or procedures are covered by the policy.  
However, a health insurance policy may provide for a different 
amount of payment or reimbursement for scheduled services or 
procedures when performed by an advanced practice nurse, a nurse 
first assistant, licensed surgical assistant, or physician 
assistant provided the reimbursement methodology used to calculate 
the payment for the service or procedure is the same methodology 
used to calculate the payment when the service or procedure is 
provided by a physician.  This subsection applies only to the rate 
of payment or reimbursement under a health insurance policy made by 
an insurance company, association, or organization to which this 
article applies to the types of practitioners described by this 
subsection.  This subsection does not apply to cost-sharing amounts 
to be paid by a covered person, such as coinsurance, copayments, or 
deductibles.
	SECTION 2.  This Act takes effect September 1, 2003, and 
applies only to an insurance policy that is delivered, issued for 
delivery, or renewed on or after January 1, 2004.  A policy that is 
delivered, issued for delivery, or renewed before January 1, 2004,  
is governed by the law as it existed immediately before the 
effective date of this Act, and that law is continued in effect for 
this purpose.