Texas 2017 - 85th Regular

Texas House Bill HB3216 Compare Versions

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

Old	New	Differences
1	1	85R6881 BEE-D
2	2	By: Bonnen of Galveston H.B. No. 3216
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to maintenance of certification by a physician or an
8	8	applicant for a license to practice medicine in this state.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subtitle F, Title 8, Insurance Code, is amended
11	11	by adding Chapter 1461 to read as follows:
12	12	CHAPTER 1461. DISCRIMINATION AGAINST PHYSICIAN BASED ON
13	13	MAINTENANCE OF CERTIFICATION
14	14	Sec. 1461.001. DEFINITIONS. In this chapter:
15	15	(1) "Enrollee" means an individual who is eligible to
16	16	receive health care services under a managed care plan.
17	17	(2) "Maintenance of certification" has the meaning
18	18	assigned by Section 151.002, Occupations Code.
19	19	(3) "Managed care plan" means a health benefit plan
20	20	under which medical care services are provided to enrollees through
21	21	contracts with physicians and that requires enrollees to use
22	22	participating physicians or that provides a different level of
23	23	coverage for enrollees who use participating physicians. The term
24	24	includes a health benefit plan issued by:
25	25	(A) a health maintenance organization;
26	26	(B) a preferred provider benefit plan issuer; or
27	27	(C) any other entity that issues a health benefit
28	28	plan, including an insurance company.
29	29	(4) "Participating physician" means a physician who
30	30	has directly or indirectly contracted with a health benefit plan
31	31	issuer to provide services to enrollees.
32	32	(5) "Physician" means a person licensed to practice
33	33	medicine in this state.
34	34	Sec. 1461.002. APPLICABILITY. (a) This chapter applies to
35	35	a physician regardless of whether the physician is a participating
36	36	physician.
37	37	(b) This chapter applies to a person to whom a managed care
38	38	plan issuer contracts to:
39	39	(1) process or pay claims;
40	40	(2) obtain the services of physicians to provide
41	41	medical care services to enrollees; or
42	42	(3) issue verifications or preauthorizations.
43	43	Sec. 1461.003. DISCRIMINATION BASED ON MAINTENANCE OF
44	44	CERTIFICATION. A managed care plan issuer may not differentiate
45	45	between physicians based solely on a physician's maintenance of
46	46	certification in regard to:
47	47	(1) paying the physician;
48	48	(2) reimbursing the physician; or
49	49	(3) directly or indirectly contracting with the
50	50	physician to provide services to enrollees.
51	51	SECTION 2. Section 151.002(a), Occupations Code, is amended
52	52	by adding Subdivision (6-b) to read as follows:
53	53	(6-b) "Maintenance of certification" means the
54	54	satisfactory completion of periodic recertification examinations
55	55	required to maintain certification after an initial certification
56	56	under a medical specialty member board, including the member boards
57	57	of the American Board of Medical Specialties or the specialty
58	58	certifying boards of the American Osteopathic Association.
59	59	SECTION 3. Subchapter B, Chapter 151, Occupations Code, is
60	60	amended by adding Section 151.0515 to read as follows:
61	61	Sec. 151.0515. DISCRIMINATION BASED ON MAINTENANCE OF
62	62	CERTIFICATION. A hospital, institution, or program that is
63	63	licensed by this state, is operated by this state or a political
64	64	subdivision of this state, or directly or indirectly receives state
65	65	financial assistance may not differentiate between physicians
66	66	based solely on a physician's maintenance of certification.
67	67	SECTION 4. Section 155.003, Occupations Code, is amended by
68	68	amending Subsection (d) and adding Subsection (d-1) to read as
69	69	follows:
70	70	(d) Except as provided by Subsection (d-1), in [In] addition
71	71	to the other requirements prescribed by this subtitle, the board
72	72	may require an applicant to comply with other requirements that the
73	73	board considers appropriate.
74	74	(d-1) The board may not require maintenance of
75	75	certification by an applicant for the applicant to be eligible for a
76	76	license under this chapter.
77	77	SECTION 5. Section 156.001, Occupations Code, is amended by
78	78	adding Subsection (f) to read as follows:
79	79	(f) The board may not adopt a rule requiring maintenance of
80	80	certification by a license holder for the license holder to be
81	81	eligible for an initial or renewal registration permit.
82	82	SECTION 6. This Act takes effect September 1, 2017.