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A BILL TO BE ENTITLED
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AN ACT
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relating to the provision of certain historical claims data and |
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other information to school districts and other participating |
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entities in the Texas school employees uniform group health |
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coverage program. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter A, Chapter 1579, Insurance Code, is |
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amended by adding Section 1579.009 to read as follows: |
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Sec. 1579.009. PARTICIPATING ENTITY REQUEST FOR CERTAIN |
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INFORMATION. (a) Subject to Subsection (b), the trustee shall |
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provide to a participating entity any historical claims data, |
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enrollment information, or other relevant information available to |
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the trustee as requested by the entity in connection with a search |
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for alternative health benefit plan coverage for the entity's |
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employees and the employees' dependents. The information provided |
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must include, for each tier of group coverage and for the five-year |
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period preceding the date of the request: |
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(1) the monthly claims experience history; |
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(2) information concerning the type of illness or |
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injury and the ongoing status of the illness or injury for: |
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(A) each medical claim that exceeds $50,000; and |
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(B) each related series of medical claims for the |
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same covered individual and for the same diagnosis that exceeds |
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$50,000; |
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(3) any other information requested by the |
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participating entity concerning covered individuals who are |
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responsible for a claim or claims that total a large amount, as |
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specified by the requesting participating entity; |
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(4) information concerning prescription drug claims |
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and costs; and |
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(5) plan enrollment. |
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(b) The information provided by the trustee under this |
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section may not include any personally identifying information of a |
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covered individual, including any information that would identify a |
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named covered individual as having a particular medical condition. |
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(c) The trustee shall provide the information requested |
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under this section at no cost to the requesting participating |
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entity. |
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SECTION 2. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2019. |