Texas 2009 - 81st Regular

Texas House Bill HB2183 Compare Versions

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

Old	New	Differences
1	1	81R1755 YDB-D
2	2	By: Zerwas H.B. No. 2183
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the regulation of independent freestanding emergency
8	8	medical care facilities and urgent care clinics; providing
9	9	penalties; creating an offense.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Subtitle B, Title 4, Health and Safety Code, is
12	12	amended by adding Chapter 254 to read as follows:
13	13	CHAPTER 254. INDEPENDENT FREESTANDING EMERGENCY MEDICAL CARE AND
14	14	URGENT CARE FACILITIES
15	15	SUBCHAPTER A. GENERAL PROVISIONS
16	16	Sec. 254.001. DEFINITIONS. In this chapter:
17	17	(1) "Department" means the Department of State Health
18	18	Services.
19	19	(2) "Executive commissioner" means the executive
20	20	commissioner of the Health and Human Services Commission.
21	21	(3) "Facility" means an independent freestanding
22	22	emergency medical care facility or an urgent care clinic.
23	23	(4) "Independent freestanding emergency medical care
24	24	facility" means a health care facility, structurally separate and
25	25	distinct from a hospital, that:
26	26	(A) receives and treats individuals requiring
27	27	treatment or stabilization of an emergency or immediate medical
28	28	condition;
29	29	(B) determines if an individual has an emergency
30	30	or immediate medical condition; or
31	31	(C) except for mass trauma preparation or
32	32	planning, is fully capable of providing Level IV trauma care, as
33	33	defined by department rule.
34	34	(5) "Urgent care clinic" means a health care facility
35	35	that:
36	36	(A) provides episodic ambulatory medical care to
37	37	individuals outside of a hospital emergency room setting;
38	38	(B) does not require an individual to make an
39	39	appointment;
40	40	(C) provides some services typically provided in
41	41	a primary care physician's office; and
42	42	(D) treats individuals requiring treatment of an
43	43	illness or injury that requires immediate care but is not life
44	44	threatening.
45	45	[Sections 254.002-254.050 reserved for expansion]
46	46	SUBCHAPTER B. FACILITY LICENSING
47	47	Sec. 254.051. LICENSE REQUIRED. (a) Except as provided
48	48	by Section 254.052, a person may not establish or operate an
49	49	independent freestanding emergency medical care facility or an
50	50	urgent care clinic in this state without a license issued under this
51	51	chapter.
52	52	(b) Except as provided by Section 254.052, a facility,
53	53	entity, or other person may not hold itself out to the public as an
54	54	"emergency" medical facility or "urgent" medical care center or use
55	55	any similar term, as defined by department rule, that would give the
56	56	impression that the person is providing emergency medical care or
57	57	treatment or urgent medical care unless the person holds a license
58	58	issued under this chapter.
59	59	(c) Each separate facility location must have a separate
60	60	license.
61	61	(d) A license issued under this chapter is not transferable
62	62	or assignable.
63	63	Sec. 254.052. EXEMPTIONS FROM LICENSING REQUIREMENT. The
64	64	following facilities are not required to be licensed under this
65	65	chapter:
66	66	(1) a licensed hospital;
67	67	(2) a hospital that is owned or operated by this state;
68	68	(3) a facility located within or connected to a
69	69	hospital described by Subdivision (1) or (2);
70	70	(4) an independent emergency medical care facility
71	71	that is owned or operated by a hospital described by Subdivision (1)
72	72	or (2);
73	73	(5) a licensed nursing home; or
74	74	(6) a licensed ambulatory surgical center.
75	75	Sec. 254.053. LICENSE APPLICATION AND ISSUANCE. (a) An
76	76	applicant for a license under this chapter must submit an
77	77	application to the department on a form prescribed by the
78	78	department.
79	79	(b) Each application must be accompanied by a nonrefundable
80	80	license fee in an amount set by the executive commissioner.
81	81	(c) The application must contain evidence that the
82	82	facility's staff meets qualifications standards adopted for the
83	83	staff of that type of facility by the executive commissioner under
84	84	this chapter.
85	85	(d) The department shall issue a license if, after
86	86	inspection and investigation, it finds that the applicant and the
87	87	facility meet the requirements of this chapter and the standards
88	88	adopted for that type of facility by the executive commissioner
89	89	under this chapter.
90	90	(e) A renewal license fee must be paid annually or
91	91	biennially based on the schedule determined by the department.
92	92	[Sections 254.054-254.100 reserved for expansion]
93	93	SUBCHAPTER C. POWERS AND DUTIES OF
94	94	EXECUTIVE COMMISSIONER AND DEPARTMENT
95	95	Sec. 254.101. ADOPTION OF RULES. (a) The executive
96	96	commissioner shall adopt rules necessary to implement this chapter,
97	97	including rules to address, for each type of facility:
98	98	(1) requirements for the issuance, renewal, denial,
99	99	suspension, and revocation of a license to operate a facility;
100	100	(2) minimum design and construction standards for the
101	101	premises of a facility, including plumbing, heating, lighting,
102	102	ventilation, and other design standards necessary to ensure the
103	103	health and safety of the facility's patients;
104	104	(3) minimum standards for the equipment essential to
105	105	the health and welfare of the facility's patients;
106	106	(4) transfer protocols for patients requiring
107	107	advanced medical care at a hospital emergency room;
108	108	(5) minimum standards for the number of and
109	109	qualifications for the facility's professional staff and other
110	110	personnel;
111	111	(6) minimum standards for the sanitary and hygienic
112	112	conditions within the facility;
113	113	(7) requirements for the contents, maintenance, and
114	114	release of medical records;
115	115	(8) the provision of laboratory and radiological
116	116	services;
117	117	(9) the distribution and administration of drugs and
118	118	controlled substances;
119	119	(10) the establishment of a quality assurance program
120	120	for patient care; and
121	121	(11) any other aspect of the operation of a facility
122	122	that the executive commissioner considers necessary to protect the
123	123	facility's patients and the public.
124	124	(b) In adopting the rules required under Subsection (a), the
125	125	executive commissioner shall consider the statutes enacted by and
126	126	rules adopted in other states to regulate independent freestanding
127	127	emergency medical care facilities and urgent care clinics. Before
128	128	adopting rules concerning transfer protocols, the executive
129	129	commissioner must consult with physicians who provide emergency
130	130	medical care and medical consultant organizations.
131	131	(c) In adopting the rules required under Subsection (a), the
132	132	executive commissioner may adopt different minimum standards and
133	133	requirements to reflect the different services provided and the
134	134	purposes served by each type of facility.
135	135	(d) This section does not authorize the executive
136	136	commissioner to:
137	137	(1) establish the qualifications of a licensed
138	138	practitioner; or
139	139	(2) permit a person to provide health care services
140	140	who is not authorized to provide those services under another state
141	141	law.
142	142	Sec. 254.102. INSPECTIONS. The department may inspect a
143	143	facility at reasonable times as necessary to ensure compliance with
144	144	this chapter.
145	145	Sec. 254.103. MONITORING. If a facility's failure to
146	146	comply with this chapter creates a serious threat to the health and
147	147	safety of the public, the department may appoint a monitor for the
148	148	facility to ensure compliance with this chapter. The facility
149	149	shall pay the cost of the monitor.
150	150	Sec. 254.104. FEES. (a) The executive commissioner shall
151	151	set fees imposed by this chapter in amounts reasonable and
152	152	necessary to defray the cost of administering this chapter.
153	153	(b) All fees collected under this chapter shall be deposited
154	154	in the state treasury to the credit of the general revenue fund and
155	155	may be appropriated to the department only to administer and
156	156	enforce this chapter.
157	157	[Sections 254.105-254.150 reserved for expansion]
158	158	SUBCHAPTER D. FACILITY REGULATION
159	159	Sec. 254.151. FACILITY POSTING REQUIREMENTS. (a) A
160	160	facility required to be licensed under this chapter shall post at
161	161	each public entryway in a conspicuous location readily visible to a
162	162	person entering the facility a sign that includes a description of
163	163	the health care services provided by the facility.
164	164	(b) The executive commissioner by rule shall determine the
165	165	design, the size, and any required wording of the sign.
166	166	Sec. 254.152. INDEPENDENT FREESTANDING EMERGENCY MEDICAL
167	167	CARE FACILITY REQUIREMENTS. An independent freestanding emergency
168	168	medical care facility required to be licensed under this chapter
169	169	must comply with the requirements of the federal Emergency Medical
170	170	Treatment and Active Labor Act of 1986 (42 U.S.C. Section 1395dd)
171	171	that are applicable to an independent emergency medical facility
172	172	owned or operated by a hospital, including the requirement that the
173	173	facility provide emergency medical care to individuals who are
174	174	present at the facility with emergency medical conditions,
175	175	regardless of their ability to pay.
176	176	Sec. 254.153. COMPLAINTS. A person may file a complaint
177	177	with the department against a facility licensed under this chapter.
178	178	[Sections 254.154-254.200 reserved for expansion]
179	179	SUBCHAPTER E. DISCIPLINARY ACTION AND PENALTIES
180	180	Sec. 254.201. DENIAL, SUSPENSION, OR REVOCATION OF LICENSE;
181	181	PROBATION. (a) The department may deny, suspend, or revoke a
182	182	license for:
183	183	(1) a violation of this chapter or a rule adopted under
184	184	this chapter; or
185	185	(2) a history of continuing noncompliance with this
186	186	chapter or rules adopted under this chapter.
187	187	(b) The denial, suspension, or revocation of a license by
188	188	the department and the appeal from that action are governed by the
189	189	procedures for a contested case hearing under Chapter 2001,
190	190	Government Code.
191	191	(c) If the department finds that a facility is in repeated
192	192	noncompliance with this chapter or rules adopted under this chapter
193	193	but that the noncompliance does not endanger public health and
194	194	safety, the department may schedule the facility for probation
195	195	rather than suspending or revoking the facility's license. The
196	196	department shall:
197	197	(1) provide notice to the facility of the probation
198	198	and of the items of noncompliance not later than the 10th day before
199	199	the date the probation period begins; and
200	200	(2) designate a period of not less than 30 days during
201	201	which the facility remains under probation.
202	202	(d) During a facility's probationary period, the facility
203	203	must correct the items that were in noncompliance and report the
204	204	corrections to the department for approval.
205	205	(e) The department may suspend or revoke the license of a
206	206	facility that does not correct items that were in noncompliance or
207	207	that does not comply with this chapter or the rules adopted under
208	208	this chapter within the applicable probation period.
209	209	Sec. 254.202. EMERGENCY SUSPENSION. (a) The department
210	210	may issue an emergency order to suspend a license issued under this
211	211	chapter if the department has reasonable cause to believe that the
212	212	conduct of a license holder creates an immediate danger to the
213	213	public health and safety.
214	214	(b) An emergency suspension under this section is effective
215	215	on the later of:
216	216	(1) the date stated in the suspension order; or
217	217	(2) the 10th day after the date notice of the
218	218	suspension is sent to the license holder.
219	219	(c) On written request of the license holder, the department
220	220	shall conduct a hearing not earlier than the seventh day or later
221	221	than the 10th day after the date the notice of emergency suspension
222	222	is sent to the license holder to determine if the suspension is to
223	223	take effect or be modified or rescinded.
224	224	(d) A hearing and any appeal under this section are governed
225	225	by the department's rules for a contested case hearing and Chapter
226	226	2001, Government Code.
227	227	Sec. 254.203. INJUNCTION. (a) The department may petition
228	228	a district court for a temporary restraining order to restrain a
229	229	continuing violation of this chapter or the rules adopted under
230	230	this chapter if the department finds that the violation creates an
231	231	immediate threat to the health and safety of the patients of a
232	232	facility.
233	233	(b) A district court, on petition of the department and on a
234	234	finding by the court that a person is violating this chapter or the
235	235	rules adopted under this chapter, may by injunction:
236	236	(1) prohibit a person from continuing the violation;
237	237	(2) restrain or prevent the establishment or operation
238	238	of a facility without a license issued under this chapter; or
239	239	(3) grant any other injunctive relief warranted by the
240	240	facts.
241	241	(c) The attorney general shall institute and conduct a suit
242	242	authorized by this section at the request of the department.
243	243	(d) Venue for a suit brought under this section is in the
244	244	county in which the facility is located or in Travis County.
245	245	Sec. 254.204. IMPOSITION OF ADMINISTRATIVE PENALTY. (a)
246	246	The department may impose an administrative penalty on a person
247	247	licensed under this chapter who violates this chapter or a rule or
248	248	order adopted under this chapter. A penalty collected under this
249	249	section or Section 254.205 shall be deposited in the state treasury
250	250	in the general revenue fund.
251	251	(b) A proceeding to impose the penalty is considered to be a
252	252	contested case under Chapter 2001, Government Code.
253	253	(c) The amount of the penalty may not exceed $1,000 for each
254	254	violation, and each day a violation continues or occurs is a
255	255	separate violation for purposes of imposing a penalty. The total
256	256	amount of the penalty assessed for a violation continuing or
257	257	occurring on separate days under this subsection may not exceed
258	258	$5,000.
259	259	(d) The amount shall be based on:
260	260	(1) the seriousness of the violation, including the
261	261	nature, circumstances, extent, and gravity of the violation;
262	262	(2) the threat to health or safety caused by the
263	263	violation;
264	264	(3) the history of previous violations;
265	265	(4) the amount necessary to deter a future violation;
266	266	(5) whether the violator demonstrated good faith,
267	267	including when applicable whether the violator made good faith
268	268	efforts to correct the violation; and
269	269	(6) any other matter that justice may require.
270	270	(e) If the department initially determines that a violation
271	271	occurred, the department shall give written notice by certified
272	272	mail to the person.
273	273	(f) The notice under Subsection (e) must:
274	274	(1) include a brief summary of the alleged violation;
275	275	(2) state the amount of the recommended penalty; and
276	276	(3) inform the person of the person's right to a
277	277	hearing on the occurrence of the violation, the amount of the
278	278	penalty, or both.
279	279	(g) Within 20 days after the date the person receives the
280	280	notice under Subsection (e), the person in writing may:
281	281	(1) accept the determination and recommended penalty
282	282	of the department; or
283	283	(2) make a request for a hearing on the occurrence of
284	284	the violation, the amount of the penalty, or both.
285	285	(h) If the person accepts the determination and recommended
286	286	penalty or if the person fails to respond to the notice, the
287	287	commissioner of state health services by order shall approve the
288	288	determination and impose the recommended penalty.
289	289	(i) If the person requests a hearing, the commissioner of
290	290	state health services shall refer the matter to the State Office of
291	291	Administrative Hearings, which shall promptly set a hearing date
292	292	and give written notice of the time and place of the hearing to the
293	293	person. An administrative law judge of the State Office of
294	294	Administrative Hearings shall conduct the hearing.
295	295	(j) The administrative law judge shall make findings of fact
296	296	and conclusions of law and promptly issue to the commissioner of
297	297	state health services a proposal for a decision about the
298	298	occurrence of the violation and the amount of a proposed penalty.
299	299	(k) Based on the findings of fact, conclusions of law, and
300	300	proposal for a decision, the commissioner of state health services
301	301	by order may:
302	302	(1) find that a violation occurred and impose a
303	303	penalty; or
304	304	(2) find that a violation did not occur.
305	305	(l) A notice of the order under Subsection (k) that is sent
306	306	to the person in accordance with Chapter 2001, Government Code,
307	307	must include a statement of the right of the person to judicial
308	308	review of the order.
309	309	Sec. 254.205. PAYMENT AND COLLECTION OF ADMINISTRATIVE
310	310	PENALTY; JUDICIAL REVIEW. (a) Within 30 days after the date an
311	311	order of the commissioner of state health services under Section
312	312	254.204(k) that imposes an administrative penalty becomes final,
313	313	the person shall:
314	314	(1) pay the penalty; or
315	315	(2) file a petition for judicial review of the
316	316	commissioner's order contesting the occurrence of the violation,
317	317	the amount of the penalty, or both.
318	318	(b) Within the 30-day period prescribed by Subsection (a), a
319	319	person who files a petition for judicial review may:
320	320	(1) stay enforcement of the penalty by:
321	321	(A) paying the penalty to the court for placement
322	322	in an escrow account; or
323	323	(B) giving the court a supersedeas bond approved
324	324	by the court that:
325	325	(i) is for the amount of the penalty; and
326	326	(ii) is effective until all judicial review
327	327	of the commissioner's order is final; or
328	328	(2) request the court to stay enforcement of the
329	329	penalty by:
330	330	(A) filing with the court a sworn affidavit of
331	331	the person stating that the person is financially unable to pay the
332	332	penalty and is financially unable to give the supersedeas bond; and
333	333	(B) sending a copy of the affidavit to the
334	334	commissioner by certified mail.
335	335	(c) If the commissioner of state health services receives a
336	336	copy of an affidavit under Subsection (b)(2), the commissioner may,
337	337	not later than the fifth day after the date the copy is received,
338	338	file with the court a contest to the affidavit. The court shall
339	339	hold a hearing on the facts alleged in the affidavit as soon as
340	340	practicable and shall stay the enforcement of the penalty on
341	341	finding that the alleged facts are true. The person who files an
342	342	affidavit has the burden of proving that the person is financially
343	343	unable to pay the penalty or to give a supersedeas bond.
344	344	(d) If the person does not pay the penalty and the
345	345	enforcement of the penalty is not stayed, the penalty may be
346	346	collected. The attorney general may sue to collect the penalty.
347	347	(e) If the court sustains the finding that a violation
348	348	occurred, the court may uphold or reduce the amount of the penalty
349	349	and order the person to pay the full or reduced amount of the
350	350	penalty.
351	351	(f) If the court does not sustain the finding that a
352	352	violation occurred, the court shall order that a penalty is not
353	353	owed.
354	354	(g) If the person paid the penalty and if the amount of the
355	355	penalty is reduced or the penalty is not upheld by the court, the
356	356	court shall order, when the court's judgment becomes final, that
357	357	the appropriate amount plus accrued interest be remitted to the
358	358	person within 30 days after the date that the judgment of the court
359	359	becomes final. The interest accrues at the rate charged on loans to
360	360	depository institutions by the New York Federal Reserve Bank. The
361	361	interest shall be paid for the period beginning on the date the
362	362	penalty is paid and ending on the date the penalty is remitted.
363	363	(h) If the person gave a supersedeas bond and the penalty is
364	364	not upheld by the court, the court shall order, when the court's
365	365	judgment becomes final, the release of the bond. If the person gave
366	366	a supersedeas bond and the amount of the penalty is reduced, the
367	367	court shall order the release of the bond after the person pays the
368	368	reduced amount.
369	369	Sec. 254.206. CRIMINAL PENALTY. (a) A person commits an
370	370	offense if the person violates Section 254.051(a) or (b).
371	371	(b) An offense under this section is a misdemeanor
372	372	punishable by a fine of not more than $100 for the first offense and
373	373	not more than $200 for each subsequent offense.
374	374	(c) Each day of a continuing violation constitutes a
375	375	separate offense.
376	376	Sec. 254.207. CIVIL PENALTY. (a) A person who violates
377	377	this chapter or a rule adopted under this chapter is liable for a
378	378	civil penalty if the department determines that the violation
379	379	threatens the health and safety of a patient. A penalty under this
380	380	section is in an amount of not less than $100 and not more than $500
381	381	for each violation.
382	382	(b) Each day a violation continues constitutes a separate
383	383	violation for the purposes of this section.
384	384	(c) The attorney general may bring suit to recover a civil
385	385	penalty under this section.
386	386	SECTION 2. Chapter 1451, Insurance Code, is amended by
387	387	adding Subchapter J to read as follows:
388	388	SUBCHAPTER J. TREATMENT AT INDEPENDENT FREESTANDING EMERGENCY
389	389	MEDICAL CARE FACILITY
390	390	Sec. 1451.451. DEFINITIONS. In this subchapter:
391	391	(1) "Enrollee" means an individual covered by a health
392	392	benefit plan.
393	393	(2) "Independent freestanding emergency medical care
394	394	facility" means an independent freestanding emergency medical care
395	395	facility licensed under Chapter 254, Health and Safety Code.
396	396	(3) "Managed care plan" means a health benefit plan
397	397	under which health care services are provided to enrollees through
398	398	contracts with health care providers and that requires enrollees to
399	399	use participating providers or that provides a different level of
400	400	coverage for enrollees who use participating providers.
401	401	Sec. 1451.452. APPLICABILITY OF SUBCHAPTER. (a) This
402	402	subchapter applies only to a health benefit plan that provides
403	403	benefits for medical or surgical expenses incurred as a result of a
404	404	health condition, accident, or sickness, including an individual,
405	405	group, blanket, or franchise insurance policy or insurance
406	406	agreement, a group hospital service contract, or an individual or
407	407	group evidence of coverage or similar coverage document that is
408	408	offered by:
409	409	(1) an insurance company;
410	410	(2) a group hospital service corporation operating
411	411	under Chapter 842;
412	412	(3) a fraternal benefit society operating under
413	413	Chapter 885;
414	414	(4) a stipulated premium company operating under
415	415	Chapter 884;
416	416	(5) an exchange operating under Chapter 942;
417	417	(6) a health maintenance organization operating under
418	418	Chapter 843;
419	419	(7) a multiple employer welfare arrangement that holds
420	420	a certificate of authority under Chapter 846; or
421	421	(8) an approved nonprofit health corporation that
422	422	holds a certificate of authority under Chapter 844.
423	423	(b) This subchapter applies to group health coverage made
424	424	available by a school district in accordance with Section 22.004,
425	425	Education Code.
426	426	(c) Notwithstanding Section 172.014, Local Government Code,
427	427	or any other law, this subchapter applies to health and accident
428	428	coverage provided by a risk pool created under Chapter 172, Local
429	429	Government Code.
430	430	(d) Notwithstanding any provision in Chapter 1551, 1575,
431	431	1579, or 1601 or any other law, this subchapter applies to:
432	432	(1) a basic coverage plan under Chapter 1551;
433	433	(2) a basic plan under Chapter 1575;
434	434	(3) a primary care coverage plan under Chapter 1579;
435	435	and
436	436	(4) basic coverage under Chapter 1601.
437	437	(e) Notwithstanding any other law, a standard health
438	438	benefit plan provided under Chapter 1507 must provide the coverage
439	439	required by this subchapter.
440	440	(f) Notwithstanding Section 1501.251 or any other law, this
441	441	subchapter applies to coverage under a small employer health
442	442	benefit plan subject to Chapter 1501.
443	443	Sec. 1451.453. EXCEPTION. This subchapter does not apply
444	444	to:
445	445	(1) a plan that provides coverage:
446	446	(A) for wages or payments in lieu of wages for a
447	447	period during which an employee is absent from work because of
448	448	sickness or injury;
449	449	(B) as a supplement to a liability insurance
450	450	policy;
451	451	(C) for credit insurance;
452	452	(D) only for dental or vision care;
453	453	(E) only for hospital expenses; or
454	454	(F) only for indemnity for hospital confinement;
455	455	(2) a Medicare supplemental policy as defined by
456	456	Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);
457	457	(3) a workers' compensation insurance policy; or
458	458	(4) medical payment insurance coverage provided under
459	459	a motor vehicle insurance policy.
460	460	Sec. 1451.454. REQUIRED COVERAGE UNDER CERTAIN HEALTH
461	461	BENEFIT PLANS. A health benefit plan, other than a managed care
462	462	plan, must provide coverage for medically necessary services
463	463	provided to an enrollee by an independent freestanding emergency
464	464	medical care facility that are within the scope of the facility's
465	465	license.
466	466	Sec. 1451.455. REQUIRED COVERAGE UNDER MANAGED CARE PLANS.
467	467	(a) If an enrollee of a managed care plan, other than a plan
468	468	governed by Section 1451.456 or 1451.457, cannot reasonably reach a
469	469	participating provider, the managed care plan shall provide
470	470	reimbursement for emergency medical care services provided to an
471	471	enrollee by an independent freestanding emergency medical care
472	472	facility that are within the scope of the facility's license.
473	473	(b) Reimbursement provided under Subsection (a) must be
474	474	provided at the usual and customary rate, or at an agreed rate, and
475	475	provided until the enrollee can reasonably be expected to transfer
476	476	to a participating provider.
477	477	Sec. 1451.456. REQUIRED COVERAGE UNDER HEALTH MAINTENANCE
478	478	ORGANIZATION. A health maintenance organization shall pay for
479	479	emergency medical care services provided to an enrollee by a
480	480	non-network independent freestanding emergency medical care
481	481	facility that are within the scope of the facility's license as
482	482	required under Section 1271.155.
483	483	Sec. 1451.457. REQUIRED COVERAGE UNDER PREFERRED PROVIDER
484	484	BENEFIT PLAN. If an insured under a preferred provider benefit plan
485	485	cannot reasonably reach a participating provider, the insurer shall
486	486	provide reimbursement for emergency care services provided to the
487	487	insured by an independent freestanding emergency medical care
488	488	facility that are within the scope of the facility's license as
489	489	required by Section 1301.155.
490	490	Sec. 1451.458. NOTICE OF COVERAGE. (a) An issuer of a
491	491	health benefit plan shall provide to each individual enrolled in
492	492	the plan written notice of the coverage required under this
493	493	subchapter.
494	494	(b) The notice must be provided in accordance with rules
495	495	adopted by the commissioner.
496	496	Sec. 1451.459. RULES. The commissioner shall adopt rules
497	497	necessary to administer this subchapter.
498	498	SECTION 3. Subchapter J, Chapter 1451, Insurance Code, as
499	499	added by this Act, applies only to a health benefit plan that is
500	500	delivered, issued for delivery, or renewed on or after January 1,
501	501	2010. A health benefit plan that is delivered, issued for delivery,
502	502	or renewed before January 1, 2010, is governed by the law as it
503	503	existed immediately before the effective date of this Act, and that
504	504	law is continued in effect for that purpose.
505	505	SECTION 4. (a) Not later than September 1, 2010, an
506	506	independent freestanding emergency medical care facility and an
507	507	urgent care clinic must obtain a license as required by Chapter 254,
508	508	Health and Safety Code, as added by this Act.
509	509	(b) Not later than March 1, 2010, the executive commissioner
510	510	of the Health and Human Services Commission shall adopt rules as
511	511	required by Chapter 254, Health and Safety Code, as added by this
512	512	Act.
513	513	SECTION 5. (a) Except as provided by Subsection (b) of
514	514	this section, this Act takes effect September 1, 2009.
515	515	(b) Sections 254.201 through 254.207, Health and Safety
516	516	Code, as added by this Act, take effect September 1, 2010.