82R52 JSC-D
By: Laubenberg H.B. No. 144
A BILL TO BE ENTITLED
AN ACT
relating to payment for health care services and participation in a
health care system.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Title 8, Insurance Code, is amended by adding
Subtitle K to read as follows:
SUBTITLE K. PROVISIONS APPLICABLE TO HEALTH CARE SERVICES PROVIDED
PURSUANT TO HEALTH CARE SYSTEM
CHAPTER 1671. HEALTH CARE SERVICES PROVIDED PURSUANT TO HEALTH
CARE SYSTEM
Sec. 1671.001. DEFINITIONS. In this chapter:
(1) "Direct payment" means payment for health care
services provided to an individual or a dependent of the individual
that is made by the individual or by the individual's employer,
without a public or private third party, other than the employer,
paying for any portion of the service.
(2) "Health care system" means any public or private
entity, including a health insurer or health benefit plan, that for
the benefit of its participants:
(A) manages, enrolls individuals in, or makes
full or partial payment for health care services; or
(B) manages or processes health care data or
information.
Sec. 1671.002. DIRECT PAYMENT; HEALTH CARE SYSTEM
PARTICIPATION. (a) This state, an agency of this state, or a health
care system may not:
(1) impose a fine or penalty on an individual or the
individual's employer for direct payment for a health care service;
(2) impose a fine or penalty on a health care provider
for accepting direct payment for a health care service; or
(3) directly or indirectly require an individual,
employer, or health care provider to participate in a health care
system, including imposing a fine or penalty for failure to
participate.
(b) This section does not:
(1) affect which health care services a health care
provider or hospital is required to provide;
(2) affect which health care services are permitted by
law;
(3) prohibit care provided pursuant to a workers'
compensation claim;
(4) affect a law or rule in effect January 1, 2010; or
(5) affect the terms or conditions of a health care
system that do not:
(A) impose a fine or penalty on an individual or
the individual's employer for direct payment for a health care
service; or
(B) impose a fine or penalty on a health care
provider for accepting direct payment for a health care service.
Sec. 1671.003. CONFLICTING LAW. A law that conflicts with
this chapter is void.
SECTION 2. This Act takes effect September 1, 2011.