Texas 2015 - 84th Regular

Texas Senate Bill SB1018 Compare Versions

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

Old	New	Differences
1	1	84R10468 SCL-F
2	2	By: Hancock S.B. No. 1018
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the provision of direct primary care.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Chapter 162, Occupations Code, is amended by
10	10	adding Subchapter F to read as follows:
11	11	SUBCHAPTER F. DIRECT PRIMARY CARE
12	12	Sec. 162.251. DEFINITIONS. In this subchapter:
13	13	(1) "Direct fee" means a fee charged by a physician to
14	14	a patient or a patient's designee for primary medical care services
15	15	provided by, or to be provided by, the physician to the patient.
16	16	The term includes a fee in any form, including a:
17	17	(A) monthly retainer;
18	18	(B) membership fee;
19	19	(C) subscription fee;
20	20	(D) fee paid under a medical service agreement;
21	21	or
22	22	(E) fee for a service, visit, or episode of care.
23	23	(2) "Direct primary care" means a primary medical care
24	24	service provided by a physician to a patient in return for payment
25	25	in accordance with a direct fee.
26	26	(3) "Medical service agreement" means a signed written
27	27	agreement under which a physician agrees to provide direct primary
28	28	care services for a patient in exchange for a direct fee for a
29	29	period of time that is entered into by the physician and:
30	30	(A) the patient;
31	31	(B) the patient's legal representative,
32	32	guardian, or employer on behalf of the patient; or
33	33	(C) the patient's legal representative's or
34	34	guardian's employer on behalf of the patient.
35	35	(4) "Physician" includes a professional association
36	36	or professional limited liability company owned entirely by an
37	37	individual licensed under this subtitle.
38	38	(5) "Primary medical care service" means a routine or
39	39	general health care service of the type provided at the time a
40	40	patient seeks preventive care or first seeks health care services
41	41	for a specific health concern, is a patient's main source for
42	42	regular health care services, and includes:
43	43	(A) promoting and maintaining mental and
44	44	physical health and wellness;
45	45	(B) preventing disease;
46	46	(C) screening, diagnosing, and treating acute or
47	47	chronic conditions caused by disease, injury, or illness;
48	48	(D) providing patient counseling and education;
49	49	and
50	50	(E) providing a broad spectrum of preventive and
51	51	curative health care over a period of time.
52	52	Sec. 162.252. DIRECT PRIMARY CARE NOT INSURANCE. (a) A
53	53	physician providing direct primary care is not an insurer or health
54	54	maintenance organization, and the physician is not subject to
55	55	regulation by the Texas Department of Insurance for the direct
56	56	primary care.
57	57	(b) A medical service agreement is not health or accident
58	58	insurance or coverage under Title 8, Insurance Code, and is not
59	59	subject to regulation by the Texas Department of Insurance.
60	60	(c) A physician is not required to obtain a certificate of
61	61	authority under the Insurance Code to market, sell, or offer a
62	62	medical service agreement or provide direct primary care.
63	63	(d) A physician providing direct primary care does not
64	64	violate Section 1204.055, Insurance Code.
65	65	Sec. 162.253. INTERFERENCE PROHIBITED. (a) The board or
66	66	another state agency may not prohibit, interfere with, initiate a
67	67	legal or administrative proceeding against, or impose a fine or
68	68	penalty against:
69	69	(1) a physician solely because the physician provides
70	70	direct primary care; or
71	71	(2) a person solely because the person pays a direct
72	72	fee for direct primary care.
73	73	(b) A health insurer, health maintenance organization, or
74	74	health care provider as that term is defined by Section 105.001 may
75	75	not prohibit, interfere with, or initiate a legal proceeding
76	76	against:
77	77	(1) a physician solely because the physician provides
78	78	direct primary care; or
79	79	(2) a person solely because the person pays a direct
80	80	fee for direct primary care.
81	81	SECTION 2. This Act takes effect immediately if it receives
82	82	a vote of two-thirds of all the members elected to each house, as
83	83	provided by Section 39, Article III, Texas Constitution. If this
84	84	Act does not receive the vote necessary for immediate effect, this
85	85	Act takes effect September 1, 2015.