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A BILL TO BE ENTITLED
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AN ACT
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relating to nondiscrimination against physicians in payment for |
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telephone consultation services. |
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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 1459 to read as follows: |
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CHAPTER 1459. FAIR ACCESS TO TELEPHONE CONSULTATIONS |
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Sec. 1459.001. DEFINITIONS. In this chapter: |
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(1) "Employee benefit plan" means a plan, fund or |
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program established or maintained by an employer or employee |
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organization. |
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(2) "Health insurance policy" means any individual, |
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group, blanket, or franchise insurance policy, insurance |
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agreement, or group hospital service contract. |
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(3) "Physician" means an individual licensed to |
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practice medicine in this state; a professional association |
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composed solely of individuals licensed to practice medicine in |
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this state; a single legal entity authorized to practice medicine |
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in this state that is owned by two or more individuals licensed to |
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practice medicine in this state; a nonprofit health corporation |
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certified by the Texas Medical Board under Chapter 162, Occupations |
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Code; and a partnership composed solely of individuals licensed to |
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practice medicine in this state. |
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Sec. 1459.002. NONDISCRIMINATION IN TELEPHONE CONSULTATION |
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SERVICES. (a) An employee benefit plan or health insurance policy |
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may not: |
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(1) prohibit a physician from charging for a telephone |
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consultation with a covered patient if that employee benefit plan |
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or health insurance policy allows any other person to charge for |
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telephone consultations with covered patients; |
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(2) deny payment to a physician for a medically |
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necessary telephone consultation with a covered patient if that |
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employee benefit plan or health insurance policy pays any other |
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person for telephone consultations with covered patients; or |
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(3) discriminate against physicians in determining |
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payment amounts for medically necessary telephone consultations |
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provided to covered patients if that employee benefit plan or |
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health insurance policy pays any other person for telephone |
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consultations with covered patients. |
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(b) Nothing in this Section shall be construed as |
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prohibiting an employee benefit plan or health insurance policy |
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from paying a physician for medically necessary telephone |
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consultations. |
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SECTION 2. This Act takes effect September 1, 2013. |