80R2459 CLG-F

By: Leibowitz H.B. No. 338

A BILL TO BE ENTITLED

AN ACT

relating to the collection and reporting of employment information regarding beneficiaries of certain health care services and employee health benefit plan coverage.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Chapter 531, Government Code, is amended by adding Subchapter M to read as follows: SUBCHAPTER M. DATA COLLECTION AND REPORTING RELATING TO EMPLOYERS OF BENEFICIARIES OF CERTAIN HEALTH CARE SERVICES

Sec. 531.451. DEFINITIONS. In this subchapter:

(1) "Charitable health care or services" means all health care or services provided for free or at discounted amounts at or below actual costs based on a person's ability to pay. The term does not include care or services covered by the Medicare program or provided through public health care assistance.

(2) "Health benefit plan" means a group, blanket, or franchise insurance policy, a certificate issued under a group policy, a group hospital service contract, or a group subscriber contract or evidence of coverage issued by a health maintenance organization that provides benefits for health care services. The term does not include:

(A) accident-only or disability income insurance coverage or a combination of accident-only and disability income insurance coverage;

(B) credit-only insurance coverage;

(C) disability insurance coverage;

(D) coverage for a specified disease or illness;

(E) Medicare services under a federal contract;

(F) Medicare supplement and Medicare Select benefit plans regulated in accordance with federal law;

(G) long-term care coverage or benefits, nursing home care coverage or benefits, home health care coverage or benefits, community-based care coverage or benefits, or any combination of those coverages or benefits;

(H) coverage that provides limited-scope dental or vision benefits;

(I) coverage provided by a single service health maintenance organization;

(J) workers' compensation insurance coverage or similar insurance coverage;

(K) hospital indemnity or other fixed indemnity insurance coverage;

(L) reinsurance contracts issued on a stop-loss, quota-share, or similar basis;

(M) short-term major medical contracts;

(N) liability insurance coverage, including general liability insurance coverage and automobile liability insurance coverage, and coverage issued as a supplement to liability insurance coverage, including automobile medical payment insurance coverage;

(O) coverage for on-site medical clinics;

(P) coverage that provides other limited benefits specified by federal regulations; or

(Q) other coverage that:

(i) is similar to the coverage described by this subdivision under which benefits for medical care are secondary or incidental to other coverage benefits; and

(ii) is specified by federal regulations.

(3) "Hospital" means a general or special hospital licensed under Chapter 241, Health and Safety Code.

(4) "Large employer" means a person engaged in an industry affecting commerce who has 1,000 or more employees for each working day in each of 20 or more calendar weeks in the current or preceding calendar year. The term includes this state or a political subdivision of this state.

(5) "Proposed beneficiary of charitable health care or services" means the person on whose behalf charitable health care or services are requested, including the person making the request or a spouse, dependent child, or other dependent of the person making the request.

(6) "Proposed beneficiary of public health care assistance" means the person on whose behalf an application for public health care assistance is filed, including the applicant or a dependent child or other dependent of the applicant.

(7) "Public health care assistance" means:

(A) medical assistance under Chapter 32, Human Resources Code;

(B) health benefits coverage under Chapter 62 or 63, Health and Safety Code;

(C) health care assistance provided by a county under Chapter 61, Health and Safety Code; or

(D) medical assistance or benefits provided by a public health care program not described in this subdivision that is administered by the commission or a health and human services agency.

Sec. 531.452. APPLICATION FOR PUBLIC HEALTH CARE ASSISTANCE; EMPLOYMENT INFORMATION. (a) The executive commissioner by rule shall require a person applying for public health care assistance to identify the employer or employers of the proposed beneficiary of the assistance.

(b) If the proposed beneficiary of the public health care assistance is not employed, the applicant shall identify the employer or employers of a person who is legally liable for the proposed beneficiary's support, including the employer of the proposed beneficiary's spouse, if any.

Sec. 531.453. REQUEST FOR CERTAIN CHARITABLE HEALTH CARE OR SERVICES; EMPLOYMENT INFORMATION. (a) Each hospital shall require a person requesting charitable health care or services from the hospital to identify the employer or employers of the proposed beneficiary of the care or services.

(b) If the proposed beneficiary of charitable health care or services provided by the hospital is not employed, the applicant shall identify the employer or employers of a person who is legally liable for the proposed beneficiary's support, including the employer of the proposed beneficiary's spouse, if any.

(c) On at least an annual basis, each hospital shall provide to the commission the employer information received under this section with respect to each person receiving charitable health care or services at the hospital.

Sec. 531.454. LARGE EMPLOYER INFORMATION REGARDING HEALTH BENEFIT PLAN COVERAGE FOR EMPLOYEES. (a) For purposes of reporting under Section 531.457, the commission shall develop and maintain a program to collect information regarding which large employers provide health benefit plan coverage to their employees and which large employers do not.

(b) The commission may obtain information from large employers and health benefit plan issuers as necessary to implement this section.

Sec. 531.455. RULEMAKING AUTHORITY. The executive commissioner shall adopt rules as necessary to implement this subchapter, including rules relating to:

(1) any required reporting by employers or health benefit plan issuers; and

(2) reporting time frames and procedures.

Sec. 531.456. COOPERATION OF TEXAS WORKFORCE COMMISSION AND TEXAS DEPARTMENT OF INSURANCE. (a) On request of the commission, the Texas Workforce Commission shall provide to the commission information regarding employers that is appropriate to the implementation of this subchapter.

(b) On request of the commission, the commissioner of insurance shall provide to the commission information that is appropriate to the implementation of Section 531.454.

Sec. 531.457. ANNUAL REPORT. (a) In this section:

(1) "Beneficiary of charitable health care or services provided by a hospital" means a person who received charitable health care or services at a hospital or who has a spouse, dependent child, or other dependent who received that care or those services.

(2) "Beneficiary of public health care assistance" means a person who is receiving public health care assistance or who has a spouse, dependent child, or other dependent who is receiving that assistance.

(b) Not later than February 1 of each year, the commission, after compiling and analyzing the information received under this subchapter, shall prepare and submit to the governor, lieutenant governor, speaker of the house of representatives, and presiding officer of the standing committee in each house of the legislature with primary jurisdiction over the commission a written report regarding employers identified under Sections 531.452 and 531.453 during the immediately preceding calendar year. The report must include:

(1) the name and business address of each large employer in this state that employs 50 or more persons in a calendar year who are beneficiaries of public health care assistance or charitable health care or services provided by a hospital;

(2) for each large employer described by Subdivision (1):

(A) the total number of employees receiving public health care assistance;

(B) the total number of employees' spouses, dependent children, or other dependents receiving public health care assistance;

(C) the total number of employees receiving charitable health care or services at a hospital;

(D) the total number of employees' spouses, dependent children, or other dependents receiving charitable health care or services at a hospital; and

(E) whether the employer offers health benefit plan coverage to its employees; and

(3) the commission's analysis of the fiscal impact on this state of providing public health care assistance to the persons described by Subdivisions (2)(A) and (B).

(c) The report may not include the name of a beneficiary of public health care assistance or charitable health care or services provided by a hospital or other information that is made confidential by law.

(d) The commission shall also make the report available to the public on the commission's Internet website.

(e) The commission shall provide a copy of the report in written form to any person requesting the report.

SECTION 2. (a) The executive commissioner of the Health and Human Services Commission shall adopt any rules necessary to implement Subchapter M, Chapter 531, Government Code, as added by this Act, not later than January 1, 2008. Each person applying for public health care assistance and each hospital shall comply with the requirements imposed by Sections 531.452 and 531.453, Government Code, as added by this Act, beginning not later than the date specified by rules adopted by the executive commissioner or January 1, 2008, whichever is earlier.

(b) The Health and Human Services Commission shall submit the initial report required by Section 531.457(b), Government Code, as added by this Act, not later than February 1, 2009.

SECTION 3. This Act takes effect September 1, 2007.