By:  Taylor (Senate Sponsor - Jackson)                            H.B. No. 1030
	(In the Senate - Received from the House May 16, 2005; 
May 17, 2005, read first time and referred to Committee on State 
Affairs; May 20, 2005, reported favorably by the following vote:  
Yeas 8, Nays 0; May 20, 2005, sent to printer.)


A BILL TO BE ENTITLED

AN ACT


relating to availability of preferred providers.                            
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Subchapter A, Chapter 1301, Insurance Code, as 
effective April 1, 2005, is amended by adding Sections 1301.0045 
and 1301.0046 to read as follows:
	Sec. 1301.0045.  CONSTRUCTION OF CHAPTER.  Except as 
provided by Section 1301.0046, this chapter may not be construed to 
limit the level of reimbursement or the level of coverage, 
including deductibles, copayments, coinsurance, or other 
cost-sharing provisions, that are applicable to preferred 
providers or nonpreferred providers.
	Sec. 1301.0046.  COINSURANCE REQUIREMENTS FOR SERVICES OF 
NONPREFERRED PROVIDERS.  The insured's coinsurance applicable to 
payment to nonpreferred providers may not exceed 50 percent of the 
total covered amount applicable to the medical or health care 
services.
	SECTION 2.  Section 1301.007, Insurance Code, as effective 
April 1, 2005, is amended to read as follows:
	Sec. 1301.007.  RULES.  The commissioner shall adopt rules 
as necessary to:  
		(1)  implement this chapter; and                                              
		(2)  ensure reasonable accessibility and availability 
of preferred provider services [benefits and basic level benefits] 
to residents of this state.
	SECTION 3.  This Act applies only to an insurance policy, 
certificate, or contract delivered, issued for delivery, or renewed 
on or after January 1, 2006.  A policy, certificate, or contract 
delivered, issued for delivery, or renewed before January 1, 2006, 
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 4.  This Act takes effect September 1, 2005.                           



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