Texas 2011 - 82nd Regular

Texas House Bill HB1864 Compare Versions

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Old	New	Differences
1	1	82R8992 TRH-F
2	2	By: Smithee, Eiland H.B. No. 1864
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to a prohibition on the coercion of therapeutic
8	8	optometrists and ophthalmologists by managed care plans.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 1451.153, Insurance Code, is amended by
11	11	amending Subsection (a) and adding Subsection (c) to read as
12	12	follows:
13	13	(a) A managed care plan may not:
14	14	(1) discriminate against a health care practitioner
15	15	because the practitioner is an optometrist, therapeutic
16	16	optometrist, or ophthalmologist;
17	17	(2) restrict or discourage a plan participant from
18	18	obtaining covered vision or medical eye care services or procedures
19	19	from a participating optometrist, therapeutic optometrist, or
20	20	ophthalmologist solely because the practitioner is an optometrist,
21	21	therapeutic optometrist, or ophthalmologist;
22	22	(3) exclude an optometrist, therapeutic optometrist,
23	23	or ophthalmologist as a participating practitioner in the plan
24	24	because the optometrist, therapeutic optometrist, or
25	25	ophthalmologist does not have medical staff privileges at a
26	26	hospital or at a particular hospital; [or]
27	27	(4) exclude an optometrist, therapeutic optometrist,
28	28	or ophthalmologist as a participating practitioner in the plan
29	29	because the services or procedures provided by the optometrist,
30	30	therapeutic optometrist, or ophthalmologist may be provided by
31	31	another type of health care practitioner; or
32	32	(5) as a condition for a therapeutic optometrist or
33	33	ophthalmologist to be included in one or more of the plan's medical
34	34	panels, require the therapeutic optometrist or ophthalmologist to
35	35	be included in, or to accept the terms of payment under or for, a
36	36	particular vision panel in which the therapeutic optometrist or
37	37	ophthalmologist does not otherwise wish to be included.
38	38	(c) For the purposes of Subsection (a)(5), "medical panel"
39	39	and "vision panel" have the meanings assigned by Section
40	40	1451.154(a).
41	41	SECTION 2. The change in law made by this Act applies only
42	42	to a contract entered into or renewed by a therapeutic optometrist
43	43	or ophthalmologist and an issuer of a managed care plan on or after
44	44	January 1, 2012. A contract entered into or renewed before January
45	45	1, 2012 is governed by the law in effect immediately before the
46	46	effective date of this Act, and that law is continued in effect for
47	47	that purpose.
48	48	SECTION 3. This Act takes effect September 1, 2011.