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A BILL TO BE ENTITLED
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AN ACT
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relating to prohibiting certain ranking of physicians by health |
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benefit plans. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subtitle F, Title 8, Insurance Code, is amended |
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by adding Chapter 1460 to read as follows: |
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CHAPTER 1460. CERTAIN PHYSICIAN RANKING BY HEALTH BENEFIT PLANS |
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PROHIBITED |
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Sec. 1460.001. DEFINITIONS. In this chapter: |
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(1) "Health benefit plan issuer" means an entity |
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authorized under this code or another insurance law of this state |
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that provides health insurance or health benefits in this state, |
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including: |
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(A) an insurance company; |
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(B) a group hospital service corporation |
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operating under Chapter 842; |
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(C) a health maintenance organization operating |
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under Chapter 843; and |
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(D) a stipulated premium company operating under |
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Chapter 884. |
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(2) "Physician" means an individual licensed to |
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practice medicine in this state or another state of the United |
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States. |
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Sec. 1460.002. PHYSICIAN RANKING PROHIBITED. (a) A health |
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benefit plan issuer may not: |
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(1) establish ranking programs for use in the |
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provision of medical services by the health benefit plan under |
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which certain physicians are presented as superior in: |
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(A) the quality of medical care provided; or |
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(B) efficiency in the provision of medical |
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services; or |
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(2) otherwise rank physicians in a manner that is not |
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authorized under this code or Subtitle B, Title 3, Occupations |
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Code. |
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(b) A health benefit plan issuer may not use advertising, |
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promotional materials, or other information provided to an |
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applicant for insurance coverage, an insured, or an enrollee, under |
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which certain physicians are ranked as superior in: |
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(1) the quality of medical care provided; or |
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(2) efficiency in the provision of medical services. |
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Sec. 1460.003. RULES. The commissioner shall adopt rules |
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in the manner prescribed by Subchapter A, Chapter 36, as necessary |
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to implement this chapter. |
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Sec. 1460.004. SANCTIONS. A health benefit plan issuer |
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that violates this chapter is subject to sanctions under Chapter |
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82. |
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SECTION 2. (a) A health benefit plan issuer shall comply |
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with Chapter 1460, Insurance Code, not later than December 31, |
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2007. |
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(b) A health benefit plan issuer is not subject to sanctions |
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under Section 1460.004, as added by this Act, before January 1, |
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2008. |
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SECTION 3. This Act takes effect September 1, 2007. |