By: Johnson  S.B. No. 1003
         (In the Senate - Filed February 17, 2023; March 3, 2023,
  read first time and referred to Committee on Health & Human
  Services; April 3, 2023, reported adversely, with favorable
  Committee Substitute by the following vote:  Yeas 9, Nays 0;
  April 3, 2023, sent to printer.)
Click here to see the committee vote
 
  COMMITTEE SUBSTITUTE FOR S.B. No. 1003 By:  Perry
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
  relating to disclosure requirements for health care provider
  directories maintained by certain health benefit plan issuers.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 1451.501(1-a), Insurance Code, is
  amended to read as follows:
               (1-a)  "Facility-based physician or provider" means a
  physician or health care provider [radiologist, anesthesiologist,
  pathologist, emergency department physician, neonatologist, or
  assistant surgeon]:
                     (A)  to whom a facility has granted clinical
  privileges; and
                     (B)  who provides services to patients of the
  facility under those clinical privileges.
         SECTION 2.  Section 1451.504, Insurance Code, is amended by
  amending Subsections (c) and (d) and adding Subsection (e) to read
  as follows:
         (c)  Except as provided by Subsection (e), for [For] each
  health care provider that is a facility included in the directory
  under this section, the directory must:
               (1)  list under the facility name separate headings for
  specialties, including radiologists, anesthesiologists, nurse
  anesthetists, pathologists, emergency department physicians,
  neonatologists, nurse midwives, surgical assistants, physical
  therapists, occupational therapists, speech-language
  pathologists, and any other specialty identified by commissioner
  rule [and assistant surgeons];
               (2)  list under each heading described by Subdivision
  (1) each facility-based physician or provider described by
  Subsection (a) practicing in the specialty corresponding with that
  heading that is a preferred provider, exclusive provider, or
  network physician or provider;
               (3)  for the facility and each facility-based physician
  or provider described by Subdivision (2), clearly indicate each
  health benefit plan issued by the issuer that may provide coverage
  for the services provided by that facility or facility-based 
  physician or provider; and
               (4)  include the facility in a listing of all
  facilities included in the directory indicating:
                     (A)  the name of the facility;
                     (B)  the municipality in which the facility is
  located or county in which the facility is located if the facility
  is in the unincorporated area of the county;
                     (C)  for each specialty of facility-based
  physician or provider practicing at the facility, the name, street
  address, and telephone number of any facility-based physician or
  provider that is a preferred provider, exclusive provider, or
  network physician or provider or of the physician or provider group
  in which the facility-based physician or provider practices;
                     (D)  each health benefit plan issued by the issuer
  that may provide coverage for the services provided by the
  facility; and
                     (E)  each health benefit plan issued by the issuer
  that may provide coverage for the services provided by each
  facility-based physician or provider group.
         (d)  The directory must list a facility-based physician or
  provider individually and, if the physician or provider belongs to
  a physician or provider group, as part of the physician or provider
  group.
         (e)  The directory is not required to list a physician or
  health care provider who is employed by the facility.
         SECTION 3.  A health benefit plan issuer shall update the
  issuer's physician and health care provider directory and Internet
  website to conform with Subchapter K, Chapter 1451, Insurance Code,
  as amended by this Act, not later than January 1, 2024.
         SECTION 4.  This Act takes effect September 1, 2023.
 
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