| |
| |
|
|
A BILL TO BE ENTITLED
|
|
|
AN ACT
|
|
|
relating to a prohibition on bids by certain insurance and health |
|
|
benefit providers to administer or provide coverage under certain |
|
|
group benefit plans for governmental employees. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. Subchapter E, Chapter 1551, Insurance Code, is |
|
|
amended by adding Section 1551.2131 to read as follows: |
|
|
Sec. 1551.2131. CERTAIN CARRIERS PROHIBITED FROM BIDDING. |
|
|
(a) The commissioner shall provide notice to the board of trustees |
|
|
if the commissioner finds that a carrier has terminated a contract |
|
|
with a physician or provider for the provision of services solely |
|
|
because the physician or provider informed an enrollee in a health |
|
|
benefit plan offered or administered by the carrier of the full |
|
|
range of physicians and providers, including out-of-network |
|
|
providers, available to the enrollee after previously being |
|
|
sanctioned or penalized by the department for engaging in the |
|
|
conduct described by this subsection. |
|
|
(b) If the board of trustees receives notice under |
|
|
Subsection (a) regarding a carrier, the carrier is prohibited from |
|
|
submitting a bid under Section 1551.212 or 1551.213 for two |
|
|
competitive bidding cycles. |
|
|
SECTION 2. Subchapter C, Chapter 1575, Insurance Code, is |
|
|
amended by adding Section 1575.1061 to read as follows: |
|
|
Sec. 1575.1061. CERTAIN HEALTH CARE PROVIDERS PROHIBITED |
|
|
FROM BIDDING. (a) The commissioner shall provide notice to the |
|
|
trustee if the commissioner finds that a health care provider has |
|
|
terminated a contract with a physician or provider for the |
|
|
provision of services solely because the physician or provider |
|
|
informed an enrollee in a health benefit plan offered or |
|
|
administered by the health care provider of the full range of |
|
|
physicians and providers, including out-of-network providers, |
|
|
available to the enrollee after previously being sanctioned or |
|
|
penalized by the department for engaging in the conduct described |
|
|
by this subsection. |
|
|
(b) If the trustee receives notice under Subsection (a) |
|
|
regarding a health care provider described by Section 1575.109, the |
|
|
health care provider is prohibited from submitting a bid under |
|
|
Section 1575.106 for two competitive bidding cycles. |
|
|
SECTION 3. Subchapter B, Chapter 1579, Insurance Code, is |
|
|
amended by adding Section 1579.0541 to read as follows: |
|
|
Sec. 1579.0541. CERTAIN HEALTH CARE AND BENEFIT PROVIDERS |
|
|
PROHIBITED FROM BIDDING. (a) The commissioner shall provide |
|
|
notice to the trustee if the commissioner finds that a health care |
|
|
or benefit provider has terminated a contract with a physician or |
|
|
provider for the provision of services solely because the physician |
|
|
or provider informed an enrollee in a health coverage plan offered |
|
|
or administered by the health care or benefit provider of the full |
|
|
range of physicians and providers, including out-of-network |
|
|
providers, available to the enrollee after previously being |
|
|
sanctioned or penalized by the department for engaging in the |
|
|
conduct described by this subsection. |
|
|
(b) If the trustee receives notice under Subsection (a) |
|
|
regarding a health care or benefit provider, the health care or |
|
|
benefit provider is prohibited from submitting a bid under Section |
|
|
1579.054 for two competitive bidding cycles. |
|
|
SECTION 4. This Act takes effect September 1, 2019. |