Texas 2009 - 81st Regular

Texas House Bill HB1276 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	81R4286 PMO-F
2	2	By: Chisum H.B. No. 1276
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the operation of health care sharing organizations.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Participants of a health care sharing
10	10	organization voluntarily assist fellow participants with the
11	11	payment of medical expenses. In many instances, participants of a
12	12	health care sharing organization provide assistance to individuals
13	13	who are without health insurance coverage and, in doing so, provide
14	14	important services that the state would otherwise have to provide.
15	15	Due to their beneficial work and religious nature, health care
16	16	sharing organizations should be statutorily recognized as
17	17	religious organizations helping to fulfill the religious beliefs of
18	18	organization participants and should not be treated in the same
19	19	manner as secular health care coverages, including insurance.
20	20	SECTION 2. Title 8, Insurance Code, is amended by adding
21	21	Subtitle K to read as follows:
22	22	SUBTITLE K. NONINSURANCE HEALTH COVERAGES
23	23	CHAPTER 1680. HEALTH CARE SHARING ORGANIZATIONS
24	24	Sec. 1680.001. SHORT TITLE. This chapter may be cited as
25	25	the Health Care Sharing Organizations Freedom to Share Act.
26	26	Sec. 1680.002. DEFINITION. In this chapter, "health care
27	27	sharing organization" means an organization qualified as a
28	28	religious organization under Section 11.20, Tax Code, that
29	29	administers a health care sharing arrangement among individuals of
30	30	the same religion based on the individuals' sincerely held
31	31	religious beliefs.
32	32	Sec. 1680.003. POWERS. A health care sharing organization
33	33	may:
34	34	(1) act as a facilitator among participants who have
35	35	financial or medical-related needs and participants with the
36	36	present ability to assist those with financial or medical-related
37	37	needs, all in accordance with the health care sharing
38	38	organization's criteria, through payments from one participant to
39	39	another;
40	40	(2) notify a participant of sharing amounts;
41	41	(3) establish additional qualifications of
42	42	participation in the health care sharing arrangement;
43	43	(4) limit the financial or medical-related needs that
44	44	may be eligible for payment among the participants;
45	45	(5) cancel a participant's participation in the health
46	46	care sharing arrangement if the participant fails to make a
47	47	specific payment to another participant before the 60th day after
48	48	the date the payment is due; and
49	49	(6) provide a written monthly statement to all
50	50	participants listing the total dollar amount of qualified needs
51	51	submitted to the organization as well as the total dollar amount
52	52	actually assigned to participants for sharing.
53	53	Sec. 1680.004. NOTICE. Each application for participation
54	54	in a health care sharing arrangement distributed directly or on
55	55	behalf of the health care sharing organization must include a
56	56	notice that is printed in no smaller than 12-point font and that
57	57	reads substantially as follows:
58	58	"This health care sharing organization is not offering
59	59	an insurance product and the health care sharing
60	60	arrangement is not being offered by or through an
61	61	insurance company. This health care sharing
62	62	organization is also not offering a discount health
63	63	care program. Whether anyone chooses to assist you
64	64	with your medical bills is voluntary, as no other
65	65	participant may be compelled to share payment of your
66	66	medical bills. This health care sharing arrangement
67	67	is not insurance or a substitute for insurance.
68	68	Whether you receive any payments for medical expenses
69	69	and whether this health care sharing organization or
70	70	arrangement continues to operate, you remain, to the
71	71	extent allowable under law, personally and fully
72	72	responsible for the payment of your own medical
73	73	bills."
74	74	Sec. 1680.005. DUTIES. (a) A health care sharing
75	75	organization shall require any adult member to sign on behalf of the
76	76	participant or, in the case of a minor or dependent child, on behalf
77	77	of the minor or dependent child, an acknowledgment that the member
78	78	has read and understands the notice described by Section 1680.004.
79	79	(b) A health care sharing organization shall retain the
80	80	signed acknowledgment described by Subsection (a) until the second
81	81	anniversary of the last date of the participant's participation in
82	82	the health care sharing arrangement.
83	83	Sec. 1680.006. CONSTRUCTION WITH OTHER LAW. (a) Chapter
84	84	76, Health and Safety Code, does not apply to a health care sharing
85	85	organization.
86	86	(b) Notwithstanding any other provision of this code, a
87	87	health care sharing organization is exempt from the operation of
88	88	the insurance laws of this state and is not subject to the
89	89	commissioner's oversight.
90	90	Sec. 1680.007. ENFORCEMENT BY ATTORNEY GENERAL.
91	91	Notwithstanding any other law, the office of the attorney general
92	92	has jurisdiction over health care sharing organizations to ensure
93	93	compliance with this chapter and for:
94	94	(1) the prevention and prosecution of deceptive trade
95	95	practices and fraud; and
96	96	(2) consumer protection.
97	97	Sec. 1680.008. NO ASSUMPTION OF RISK. Participants in a
98	98	health care sharing arrangement and the health care sharing
99	99	organization do not assume any risk or make any promise to pay the
100	100	financial or medical-related needs of other participants, and none
101	101	of the activities in this chapter give rise to an assumption of risk
102	102	or promise to pay by either the participants or the health care
103	103	sharing organization.
104	104	Sec. 1680.009. PAYMENT AMONG PARTICIPANTS. The means of
105	105	payment among participants may include an electronic transfer or a
106	106	distribution from a trust established solely for the participants'
107	107	benefit and that is audited annually by an independent auditing
108	108	firm.
109	109	Sec. 1680.010. COLLATERAL SHARING ACTIVITIES. A health
110	110	care sharing organization may:
111	111	(1) arrange for participants to share bills when a
112	112	participant experiences disability; and
113	113	(2) provide health counseling, education, and
114	114	resources to participants in the health care sharing arrangement.
115	115	Sec. 1680.011. CONTRACTUAL ARRANGEMENTS WITH OTHER
116	116	ENTITIES. A health care sharing organization may contract with an
117	117	administrator as defined by Chapter 4151, Insurance Code, or a
118	118	preferred provider organization or similar entity to facilitate the
119	119	operation of the organization.
120	120	SECTION 3. Section 101.055(a), Insurance Code, is amended
121	121	to read as follows:
122	122	(a) Section 101.051(b)(7) does not apply to:
123	123	(1) a program otherwise authorized by law that is
124	124	established:
125	125	(A) by a political subdivision of this state;
126	126	(B) by a state agency; or
127	127	(C) under Chapter 791, Government Code; [or]
128	128	(2) a multiple employer welfare arrangement that is
129	129	fully insured as defined by 29 U.S.C. Section 1144(b)(6); or
130	130	(3) a health care sharing organization operated under
131	131	Chapter 1680.
132	132	SECTION 4. Section 76.002, Health and Safety Code, is
133	133	amended to read as follows:
134	134	Sec. 76.002. CONSTRUCTION WITH [APPLICABILITY OF] OTHER
135	135	LAW. (a) In addition to the requirements of this chapter, a
136	136	program operator or marketer is subject to the applicable consumer
137	137	protection laws under Chapter 17, Business & Commerce Code.
138	138	(b) This chapter does not apply to a health care sharing
139	139	organization operated under Chapter 1680, Insurance Code.
140	140	SECTION 5. This Act takes effect immediately if it receives
141	141	a vote of two-thirds of all the members elected to each house, as
142	142	provided by Section 39, Article III, Texas Constitution. If this
143	143	Act does not receive the vote necessary for immediate effect, this
144	144	Act takes effect September 1, 2009.