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A BILL TO BE ENTITLED
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AN ACT
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relating to the licensing and regulation of physician graduates and |
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the authority of an insured to select a physician graduate under the |
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insured's health insurance policy; requiring an occupational |
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license; authorizing fees. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Chapter 155, Occupations Code, is amended by |
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adding Subchapter E to read as follows: |
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SUBCHAPTER E. PHYSICIAN GRADUATE |
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Sec. 155.201. DEFINITIONS. In this subchapter: |
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(1) "Physician graduate" means an individual issued a |
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limited license under this subchapter to practice medicine under a |
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supervising practice agreement with a sponsoring physician. |
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(2) "Sponsoring physician" means a physician who |
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enters into a supervising practice agreement with a physician |
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graduate. |
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(3) "Supervising practice agreement" means an |
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agreement between a sponsoring physician and a physician graduate |
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regarding the supervision by the sponsoring physician of the |
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physician graduate's practice of medicine. |
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Sec. 155.202. RULES. The board shall adopt rules in |
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accordance with this subchapter relating to the licensing and |
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regulation of physician graduates, including rules relating to: |
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(1) procedures and fees for the issuance, term, and |
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renewal of a license under this subchapter, including continuing |
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medical education requirements for renewal of the license; |
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(2) practices and requirements for the supervision of |
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physician graduates; and |
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(3) any other matter necessary to ensure protection of |
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the public, including disciplinary procedures. |
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Sec. 155.203. LICENSE ISSUANCE. On application, the board |
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shall issue a limited license to practice medicine under this |
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subchapter to an applicant who: |
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(1) is a resident of this state and is: |
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(A) a United States citizen or a legal permanent |
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resident; or |
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(B) otherwise authorized under federal law to |
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work in the United States; |
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(2) has proficiency in the English language; |
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(3) has graduated: |
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(A) in the two years preceding the date that the |
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applicant initially applies for a physician graduate license, from: |
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(i) a board-recognized accredited medical |
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school or osteopathic medical school in the United States or |
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Canada; or |
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(ii) a medical school located outside of |
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the United States and Canada that is recognized by the board as |
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acceptable; or |
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(B) if the applicant is licensed in good standing |
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to practice medicine in another country, from a medical school |
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located outside of the United States and Canada that is recognized |
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by the board as acceptable; |
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(4) has passed the first and second components of the |
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United States Medical Licensing Examination or equivalent |
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components of another board-approved licensing examination |
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described by Section 155.0511; |
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(5) is not enrolled in a board-approved postgraduate |
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residency program; and |
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(6) meets any other requirement prescribed by board |
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rule. |
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Sec. 155.204. FEES. The amount of a fee for the issuance or |
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renewal of a license under this subchapter may not exceed the amount |
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of a fee for the issuance or renewal of a physician assistant |
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license under Chapter 204. |
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Sec. 155.205. SPONSORING PHYSICIAN. (a) A physician is |
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eligible to enter into a supervising practice agreement as a |
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sponsoring physician if the physician: |
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(1) holds a full and unrestricted license to practice |
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medicine issued under this subtitle; |
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(2) has not been and is not currently the subject of |
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disciplinary action by the board or the medical licensing authority |
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of any other jurisdiction; |
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(3) is certified by a medical specialty member board |
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of: |
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(A) the American Board of Medical Specialties; or |
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(B) the American Osteopathic Association Bureau |
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of Osteopathic Specialists; and |
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(4) practices medicine in the specialty for which the |
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physician is certified under Subdivision (3). |
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(b) A sponsoring physician who enters into a supervising |
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practice agreement with a physician graduate shall comply with all |
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board rules related to the supervision of physician graduates. |
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(c) The board by rule shall establish the maximum number of |
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physician graduates that a sponsoring physician may supervise under |
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supervising practice agreements. |
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Sec. 155.206. SUPERVISING PRACTICE AGREEMENT REQUIRED. (a) |
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A physician graduate shall enter into a supervising practice |
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agreement with a sponsoring physician. |
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(b) A physician graduate who has not entered into a |
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supervising practice agreement may not practice or attempt to |
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practice medicine. |
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(c) A physician graduate who enters into a supervising |
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practice agreement may practice under the delegation and |
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supervision of another physician if: |
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(1) the sponsoring physician authorizes the practice |
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of the physician graduate under the delegation and supervision of |
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the other physician in a written document that identifies the other |
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physician by name; and |
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(2) the other physician is: |
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(A) part of the sponsoring physician's physician |
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group or facility; and |
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(B) certified in the same specialty as the |
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sponsoring physician by a medical specialty member board of: |
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(i) the American Board of Medical |
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Specialties; or |
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(ii) the American Osteopathic Association |
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Bureau of Osteopathic Specialists. |
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(d) The physician profile under Section 154.006 of a |
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sponsoring physician or physician graduate must indicate in the |
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manner prescribed by board rule that the sponsoring physician or |
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physician graduate has entered into a supervising practice |
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agreement. |
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Sec. 155.207. LIMITED PRACTICE BY LICENSE HOLDER. (a) A |
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physician graduate may provide only medical services in the |
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specialty in which the physician graduate's sponsoring physician is |
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certified as described by Section 155.205(a)(3) under supervision |
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in accordance with a supervising practice agreement. |
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(b) Before a license holder under this subchapter provides a |
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treatment, consultation, or other medical service, the license |
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holder must disclose to the patient: |
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(1) that the license holder is a physician graduate; |
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and |
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(2) if asked, that the license holder has not |
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completed any formal specialized postgraduate or resident |
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training. |
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(c) A physician graduate may not prescribe a Schedule II |
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controlled substance. |
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Sec. 155.208. LIABILITY OF SUPERVISING PHYSICIAN. A |
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sponsoring physician who enters into a supervising practice |
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agreement with a physician graduate is responsible at all times for |
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the oversight of and is liable for any medical act performed or the |
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omission of any medical act by the physician graduate in the |
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provision of medical services. |
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Sec. 155.209. IDENTIFICATION REQUIREMENTS; USE OF TITLE. |
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(a) The holder of a license issued under this subchapter shall at |
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all times while practicing as a physician graduate display a |
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personal identification document identifying the license holder as |
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a physician graduate. |
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(b) A physician graduate may use the following titles or |
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abbreviations: |
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(1) "doctor"; or |
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(2) "Dr." or "doc." |
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Sec. 155.210. STATUS OF PHYSICIAN GRADUATE. A physician |
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graduate license holder is considered a general practitioner for |
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purposes of regulations of the federal Centers for Medicare and |
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Medicaid Services. |
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Sec. 155.211. LICENSE RENEWAL. The board may not renew a |
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license issued under this subchapter unless: |
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(1) the board verifies that the license holder has |
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practiced in accordance with this subchapter under a supervising |
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practice agreement with a sponsoring physician in the license term |
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preceding the application for renewal; and |
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(2) the license holder satisfies the continuing |
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medical education requirements established by board rule. |
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Sec. 155.212. DENIAL, SUSPENSION, OR REVOCATION OF LICENSE. |
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The board may deny an application for licensure or suspend or revoke |
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a license issued under this subchapter: |
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(1) for any ground provided by Chapter 164 or board |
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rule; and |
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(2) in the manner provided by Chapter 164 and board |
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rule. |
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SECTION 2. Section 1451.001, Insurance Code, is amended by |
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adding Subdivision (16-a) to read as follows: |
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(16-a) "Physician graduate" has the meaning assigned |
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by Section 155.201, Occupations Code. |
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SECTION 3. Subchapter C, Chapter 1451, Insurance Code, is |
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amended by adding Section 1451.129 to read as follows: |
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Sec. 1451.129. SELECTION OF PHYSICIAN GRADUATE. An insured |
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may select a physician graduate to provide the services scheduled |
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in the health insurance policy that are within the scope of the |
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physician graduate's license under Subchapter E, Chapter 155, |
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Occupations Code. |
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SECTION 4. Not later than January 1, 2024, the Texas Medical |
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Board shall adopt rules as necessary to implement Subchapter E, |
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Chapter 155, Occupations Code, as added by this Act. |
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SECTION 5. Section 1451.129, Insurance Code, as added by |
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this Act, applies only to a health insurance policy that is |
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delivered, issued for delivery, or renewed on or after January 1, |
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2024. |
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SECTION 6. This Act takes effect September 1, 2023. |