Texas 2015 - 84th Regular

Texas Senate Bill SR988 Compare Versions

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Old	New	Differences
1	1	By: Taylor of Galveston S.R. No. 988
2	2
3	3
4	4	SENATE RESOLUTION
5	5	BE IT RESOLVED by the Senate of the State of Texas, 84th
6	6	Legislature, Regular Session, 2015, That Senate Rule 12.03 be
7	7	suspended in part as provided by Senate Rule 12.08 to enable the
8	8	conference committee appointed to resolve the differences on
9	9	Senate Bill 684 (the relationship of certain optometrists,
10	10	therapeutic optometrists, and ophthalmologists with certain
11	11	managed care plans, including preferred provider plans) to
12	12	consider and take action on the following matter:
13	13	Senate Rules 12.03(1) and (3) are suspended to permit the
14	14	committee to change and add text not in disagreement in proposed
15	15	SECTION 3 of the bill, in added Section 1451.156, Insurance Code,
16	16	to read as follows:
17	17	SECTION 3. Subchapter D, Chapter 1451, Insurance Code,
18	18	is amended by adding Section 1451.156 to read as follows:
19	19	Sec. 1451.156. PROHIBITED CONDUCT. (a) A managed care
20	20	plan, as described by Section 1451.152(a), may not directly or
21	21	indirectly:
22	22	(1) control or attempt to control the professional
23	23	judgment, manner of practice, or practice of an optometrist or
24	24	therapeutic optometrist;
25	25	(2) employ an optometrist or therapeutic
26	26	optometrist to provide a vision care product or service as
27	27	defined by Section 1451.155;
28	28	(3) pay an optometrist or therapeutic optometrist
29	29	for a service not provided;
30	30	(4) restrict or limit an optometrist's or
31	31	therapeutic optometrist's choice of sources or suppliers of
32	32	services or materials, including optical laboratories used by
33	33	the optometrist or therapeutic optometrist to provide services
34	34	or materials to a patient; or
35	35	(5) require an optometrist or therapeutic
36	36	optometrist to disclose a patient's confidential or protected
37	37	health information unless the disclosure is authorized by the
38	38	patient or permitted without authorization under the Health
39	39	Insurance Portability and Accountability Act of 1996 (42 U.S.C.
40	40	Section 1320d et seq.) or under Section 602.053.
41	41	(b) Subsection (a)(2) does not prohibit a managed care
42	42	plan from employing an optometrist or therapeutic optometrist
43	43	for utilization review or for operations of the managed care
44	44	plan.
45	45	(c) Subsection (a)(3) does not prohibit the use of
46	46	capitation as a method of payment.
47	47	(d) Subsection (a)(4) does not restrict or limit a
48	48	managed care plan's determination of specific amounts of
49	49	coverage or reimbursement for the use of network or
50	50	out-of-network suppliers or laboratories.
51	51	(e) An optometrist or therapeutic optometrist must
52	52	disclose to a patient any business interest the optometrist or
53	53	therapeutic optometrist has in an out-of-network supplier or
54	54	manufacturer to which the optometrist or therapeutic optometrist
55	55	refers the patient.
56	56	(f) This section shall be liberally construed to prevent
57	57	managed care plans from controlling or attempting to control the
58	58	professional judgment, manner of practice, or practice of an
59	59	optometrist or therapeutic optometrist.
60	60	Explanation: The change and addition are necessary to
61	61	clarify the scope of the authority of a managed care plan to
62	62	employ an optometrist or therapeutic optometrist and to require
63	63	an optometrist or therapeutic optometrist to disclose a business
64	64	interest in an out-of-network entity to which a patient is
65	65	referred.
66	66	_______________________________
67	67	President of the Senate
68	68	I hereby certify that the
69	69	above Resolution was adopted by
70	70	the Senate on May 29, 2015, by the
71	71	following vote: Yeas 31, Nays 0.
72	72	_______________________________
73	73	Secretary of the Senate