82R8992 TRH-F
 
  By: Smithee, Eiland H.B. No. 1864
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to a prohibition on the coercion of therapeutic
  optometrists and ophthalmologists by managed care plans.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 1451.153, Insurance Code, is amended by
  amending Subsection (a) and adding Subsection (c) to read as
  follows:
         (a)  A managed care plan may not:
               (1)  discriminate against a health care practitioner
  because the practitioner is an optometrist, therapeutic
  optometrist, or ophthalmologist;
               (2)  restrict or discourage a plan participant from
  obtaining covered vision or medical eye care services or procedures
  from a participating optometrist, therapeutic optometrist, or
  ophthalmologist solely because the practitioner is an optometrist,
  therapeutic optometrist, or ophthalmologist;
               (3)  exclude an optometrist, therapeutic optometrist,
  or ophthalmologist as a participating practitioner in the plan
  because the optometrist, therapeutic optometrist, or
  ophthalmologist does not have medical staff privileges at a
  hospital or at a particular hospital; [or]
               (4)  exclude an optometrist, therapeutic optometrist,
  or ophthalmologist as a participating practitioner in the plan
  because the services or procedures provided by the optometrist,
  therapeutic optometrist, or ophthalmologist may be provided by
  another type of health care practitioner; or
               (5)  as a condition for a therapeutic optometrist or
  ophthalmologist to be included in one or more of the plan's medical
  panels, require the therapeutic optometrist or ophthalmologist to
  be included in, or to accept the terms of payment under or for, a
  particular vision panel in which the therapeutic optometrist or
  ophthalmologist does not otherwise wish to be included.
         (c)  For the purposes of Subsection (a)(5), "medical panel" 
  and "vision panel" have the meanings assigned by Section
  1451.154(a).
         SECTION 2.  The change in law made by this Act applies only
  to a contract entered into or renewed by a therapeutic optometrist
  or ophthalmologist and an issuer of a managed care plan on or after
  January 1, 2012. A contract entered into or renewed before January
  1, 2012 is governed by the law in effect immediately before the
  effective date of this Act, and that law is continued in effect for
  that purpose.
         SECTION 3.  This Act takes effect September 1, 2011.