Texas 2017 - 85th Regular

Texas House Bill HB2350 Compare Versions

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

Old	New	Differences
1	1	85R11845 PMO-D
2	2	By: Muñoz, Jr. H.B. No. 2350
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the provision of health care benefits through a network
8	8	of physicians or health care providers.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subtitle C, Title 6, Insurance Code, is amended
11	11	by adding Chapter 849 to read as follows:
12	12	CHAPTER 849. PROHIBITION OF PROVIDER NETWORKS
13	13	Sec. 849.001. PURPOSE; CERTAIN PRACTICES PROHIBITED. The
14	14	purpose of this chapter is to prohibit the provision of health care
15	15	benefits by entities such as insurers and health maintenance
16	16	organizations through provider networks, preferred providers, or
17	17	similar arrangements.
18	18	Sec. 849.002. DEFINITION. In this chapter, "health benefit
19	19	plan issuer" means:
20	20	(1) a health maintenance organization or other person
21	21	who arranges for or provides to enrollees on a prepaid basis a
22	22	health care plan, a limited health care service plan, or a single
23	23	health care service plan; and
24	24	(2) a life, health, and accident insurance company,
25	25	health and accident insurance company, health insurance company, or
26	26	other company operating under Chapter 841, 842, 884, 885, 982, or
27	27	1501, that is authorized to issue, deliver, or issue for delivery in
28	28	this state health insurance policies.
29	29	Sec. 849.003. PROHIBITION ON NETWORKS. (a) A health
30	30	benefit plan issuer may not:
31	31	(1) arrange for or provide to covered persons health
32	32	care services using a delivery network that directly or indirectly
33	33	contracts or subcontracts with physicians and other health care
34	34	providers;
35	35	(2) provide, through a policy or plan, for the payment
36	36	of a level of coverage that is different from the basic level of
37	37	coverage provided by the policy or plan if the covered person uses a
38	38	physician or health care provider, or an organization of physicians
39	39	or health care providers, who contracts to provide medical or
40	40	health care services to persons covered by the policy or plan; or
41	41	(3) otherwise provide health care benefits or arrange
42	42	for health care benefits to be provided to a covered person by
43	43	contracting directly or indirectly with a physician or health care
44	44	provider, or an organization of physicians or health care
45	45	providers, to provide medical or health care services to a covered
46	46	person on a capitation basis or otherwise.
47	47	(b) This section applies without regard to whether the
48	48	physician or health care provider who is a party to a contract
49	49	described by Subsection (a) is designated as a network provider or a
50	50	preferred provider or uses another title.
51	51	(c) Notwithstanding any other law, a health benefit plan
52	52	issuer may provide health care benefits only by indemnifying the
53	53	covered person for medical or health care expenses.
54	54	SECTION 2. The following provisions of the Insurance Code
55	55	are repealed:
56	56	(1) Chapter 258;
57	57	(2) Chapter 843;
58	58	(3) Chapter 1271;
59	59	(4) Chapter 1272;
60	60	(5) Chapter 1301;
61	61	(6) Chapter 1456;
62	62	(7) Chapter 1458;
63	63	(8) Chapter 1467; and
64	64	(9) Subchapter B, Chapter 1507.
65	65	SECTION 3. The commissioner of insurance shall adopt rules
66	66	not later than January 1, 2018, to implement Chapter 849, Insurance
67	67	Code, as added by this Act.
68	68	SECTION 4. The changes in law made by this Act apply only to
69	69	a health benefit plan that is delivered, issued for delivery, or
70	70	renewed on or after January 1, 2019. A health benefit plan
71	71	delivered, issued for delivery, or renewed before January 1, 2019,
72	72	is governed by the law as it existed immediately before the
73	73	effective date of this Act, and that law is continued in effect for
74	74	that purpose.
75	75	SECTION 5. This Act takes effect September 1, 2017.