81R4286 PMO-F
 
  By: Chisum H.B. No. 1276
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the operation of health care sharing organizations.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Participants of a health care sharing
  organization voluntarily assist fellow participants with the
  payment of medical expenses. In many instances, participants of a
  health care sharing organization provide assistance to individuals
  who are without health insurance coverage and, in doing so, provide
  important services that the state would otherwise have to provide.
  Due to their beneficial work and religious nature, health care
  sharing organizations should be statutorily recognized as
  religious organizations helping to fulfill the religious beliefs of
  organization participants and should not be treated in the same
  manner as secular health care coverages, including insurance.
         SECTION 2.  Title 8, Insurance Code, is amended by adding
  Subtitle K to read as follows:
  SUBTITLE K. NONINSURANCE HEALTH COVERAGES
  CHAPTER 1680. HEALTH CARE SHARING ORGANIZATIONS
         Sec. 1680.001.  SHORT TITLE. This chapter may be cited as
  the Health Care Sharing Organizations Freedom to Share Act.
         Sec. 1680.002.  DEFINITION.  In this chapter, "health care
  sharing organization" means an organization qualified as a
  religious organization under Section 11.20, Tax Code, that
  administers a health care sharing arrangement among individuals of
  the same religion based on the individuals' sincerely held
  religious beliefs.
         Sec. 1680.003.  POWERS.  A health care sharing organization
  may:
               (1)  act as a facilitator among participants who have
  financial or medical-related needs and participants with the
  present ability to assist those with financial or medical-related
  needs, all in accordance with the health care sharing
  organization's criteria, through payments from one participant to
  another;
               (2)  notify a participant of sharing amounts;
               (3)  establish additional qualifications of
  participation in the health care sharing arrangement;
               (4)  limit the financial or medical-related needs that
  may be eligible for payment among the participants;
               (5)  cancel a participant's participation in the health
  care sharing arrangement if the participant fails to make a
  specific payment to another participant before the 60th day after
  the date the payment is due; and
               (6)  provide a written monthly statement to all
  participants listing the total dollar amount of qualified needs
  submitted to the organization as well as the total dollar amount
  actually assigned to participants for sharing.
         Sec. 1680.004.  NOTICE. Each application for participation
  in a health care sharing arrangement distributed directly or on
  behalf of the health care sharing organization must include a
  notice that is printed in no smaller than 12-point font and that
  reads substantially as follows:
         "This health care sharing organization is not offering
  an insurance product and the health care sharing
  arrangement is not being offered by or through an
  insurance company. This health care sharing
  organization is also not offering a discount health
  care program. Whether anyone chooses to assist you
  with your medical bills is voluntary, as no other
  participant may be compelled to share payment of your
  medical bills. This health care sharing arrangement
  is not insurance or a substitute for insurance.
  Whether you receive any payments for medical expenses
  and whether this health care sharing organization or
  arrangement continues to operate, you remain, to the
  extent allowable under law, personally and fully
  responsible for the payment of your own medical
  bills."
         Sec. 1680.005.  DUTIES. (a)  A health care sharing
  organization shall require any adult member to sign on behalf of the
  participant or, in the case of a minor or dependent child, on behalf
  of the minor or dependent child, an acknowledgment that the member
  has read and understands the notice described by Section 1680.004.
         (b)  A health care sharing organization shall retain the
  signed acknowledgment described by Subsection (a) until the second
  anniversary of the last date of the participant's participation in
  the health care sharing arrangement.
         Sec. 1680.006.  CONSTRUCTION WITH OTHER LAW. (a) Chapter
  76, Health and Safety Code, does not apply to a health care sharing
  organization.
         (b)  Notwithstanding any other provision of this code, a
  health care sharing organization is exempt from the operation of
  the insurance laws of this state and is not subject to the
  commissioner's oversight.
         Sec. 1680.007.  ENFORCEMENT BY ATTORNEY GENERAL.
  Notwithstanding any other law, the office of the attorney general
  has jurisdiction over health care sharing organizations to ensure
  compliance with this chapter and for:
               (1)  the prevention and prosecution of deceptive trade
  practices and fraud; and
               (2)  consumer protection.
         Sec. 1680.008.  NO ASSUMPTION OF RISK. Participants in a
  health care sharing arrangement and the health care sharing
  organization do not assume any risk or make any promise to pay the
  financial or medical-related needs of other participants, and none
  of the activities in this chapter give rise to an assumption of risk
  or promise to pay by either the participants or the health care
  sharing organization.
         Sec. 1680.009.  PAYMENT AMONG PARTICIPANTS.  The means of
  payment among participants may include an electronic transfer or a
  distribution from a trust established solely for the participants'
  benefit and that is audited annually by an independent auditing
  firm.
         Sec. 1680.010.  COLLATERAL SHARING ACTIVITIES. A health
  care sharing organization may:
               (1)  arrange for participants to share bills when a
  participant experiences disability; and
               (2)  provide health counseling, education, and
  resources to participants in the health care sharing arrangement.
         Sec. 1680.011.  CONTRACTUAL ARRANGEMENTS WITH OTHER
  ENTITIES. A health care sharing organization may contract with an
  administrator as defined by Chapter 4151, Insurance Code, or a
  preferred provider organization or similar entity to facilitate the
  operation of the organization.
         SECTION 3.  Section 101.055(a), Insurance Code, is amended
  to read as follows:
         (a)  Section 101.051(b)(7) does not apply to:
               (1)  a program otherwise authorized by law that is
  established:
                     (A)  by a political subdivision of this state;
                     (B)  by a state agency; or
                     (C)  under Chapter 791, Government Code; [or]
               (2)  a multiple employer welfare arrangement that is
  fully insured as defined by 29 U.S.C. Section 1144(b)(6); or
               (3)  a health care sharing organization operated under
  Chapter 1680.
         SECTION 4.  Section 76.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 76.002.  CONSTRUCTION WITH [APPLICABILITY OF] OTHER
  LAW. (a) In addition to the requirements of this chapter, a
  program operator or marketer is subject to the applicable consumer
  protection laws under Chapter 17, Business & Commerce Code.
         (b)  This chapter does not apply to a health care sharing
  organization operated under Chapter 1680, Insurance Code.
         SECTION 5.  This Act takes effect immediately if it receives
  a vote of two-thirds of all the members elected to each house, as
  provided by Section 39, Article III, Texas Constitution. If this
  Act does not receive the vote necessary for immediate effect, this
  Act takes effect September 1, 2009.