87R4862 SCL-F
By: Campbell S.B. No. 1442
A BILL TO BE ENTITLED
AN ACT
relating to regulation of health care sharing ministries; providing
civil penalties.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 1681, Insurance Code, is amended by
designating Sections 1681.001 through 1681.003 as Subchapter A and
adding a subchapter heading to read as follows:
SUBCHAPTER A. HEALTH CARE SHARING MINISTRY REQUIREMENTS
SECTION 2. Sections 1681.001 and 1681.002, Insurance Code,
are amended to read as follows:
Sec. 1681.001. TREATMENT AS HEALTH CARE SHARING MINISTRY.
A faith-based, nonprofit organization that is tax-exempt under the
Internal Revenue Code of 1986 qualifies for treatment as a health
care sharing ministry under this chapter if it:
(1) limits its participants to individuals of a
similar faith;
(2) acts as a facilitator among participants who have
medical expenses [bills] and matches those participants with other
participants [with the present ability] to assist those with
medical expenses [bills] in accordance with criteria established by
the health care sharing ministry;
(3) provides for the satisfaction of the medical
expenses [bills] of a participant through contributions from one
participant to another, including through collected contributions
or from participant contributions collected by the health care
sharing ministry;
(4) provides amounts that participants may contribute
with no assumption of risk or promise to pay among the participants
and no assumption of risk or promise to pay by the health care
sharing ministry to the participants;
(5) provides a [written] monthly statement to all
participants that lists the total dollar amount of qualified
eligible sharing requests [needs] submitted to the health care
sharing ministry, as well as the amount actually shared with
[published or assigned to] participants for their contribution;
(6) discloses administrative fees and costs to
participants;
(7) provides that any card issued to a participant for
the purpose of presentation to a health care provider clearly
indicates that the participant is part of a health care sharing
ministry that is not engaging in the business of insurance;
(8) provides a written disclaimer on or accompanying
all applications and guideline materials distributed by or on
behalf of the ministry that complies with Section 1681.002; [and]
(9) does not operate a discount health care program as
defined by Section 7001.001;
(10) is exempt from federal taxation under 26 U.S.C.
Section 501(a) by being described by Section 501(c)(3) of that
code;
(11) ensures that a participant retains membership
regardless of whether the participant develops a medical condition;
(12) has been or a predecessor of the health care
sharing ministry has been in existence at all times since December
31, 1999, and medical expenses of its participants have been shared
continuously and without interruption since at least December 31,
1999;
(13) performs an annual audit that is:
(A) conducted by an independent certified public
accounting firm in accordance with generally accepted accounting
principles; and
(B) made available to the public on request; and
(14) has received a written confirmation from the
Centers for Medicare and Medicaid Services that verifies that the
health care sharing ministry satisfies federal qualifications for a
health care sharing ministry.
Sec. 1681.002. NOTICE. To qualify as a health care sharing
ministry under this chapter, the notice described by Section
1681.001(8) must read substantially as follows:
"Notice: This health care sharing ministry facilitates the
sharing of medical expenses and is not an insurance company, and
neither its guidelines nor its plan of operation is an insurance
policy. Whether anyone chooses to assist you with your medical
expenses [bills] will be totally voluntary because no other
participant will be compelled by law to contribute toward your
medical expenses [bills]. As such, participation in the ministry or
a subscription to any of its documents should never be considered to
be insurance. Regardless of whether you receive any payment for
medical expenses, whether any payment is made to a health care
provider on your behalf from collected contributions, or whether
this ministry continues to operate, you are always personally
responsible for the payment of your own medical expenses [bills].
Complaints concerning this health care sharing ministry may be
reported to the office of the Texas attorney general."
SECTION 3. Subchapter A, Chapter 1681, Insurance Code, as
added by this Act, is amended by adding Section 1681.004 to read as
follows:
Sec. 1681.004. CONTRACTING AUTHORITY. A health care
sharing ministry may:
(1) contract and negotiate with health care providers
and provider networks for the purpose of lowering medical expenses
for sharing among members; and
(2) contract with a discount health care program
registered in this state to provide participants with access to
discounts on health care services provided by health care providers
if the health care sharing ministry does not act as a program
operator as defined by Section 7001.001.
SECTION 4. Chapter 1681, Insurance Code, is amended by
adding Subchapter B to read as follows:
SUBCHAPTER B. ENFORCEMENT
Sec. 1681.051. ATTORNEY GENERAL JURISDICTION. The attorney
general has:
(1) the exclusive authority to determine whether an
organization qualifies for treatment as a health care sharing
ministry under this chapter; and
(2) exclusive jurisdiction and enforcement authority
over all complaints and compliance issues concerning health care
sharing ministries.
Sec. 1681.052. DECEPTIVE TRADE PRACTICE. A person or
organization that operates a health care sharing ministry that is
not qualified as a health care sharing ministry under this chapter
is considered to engage in a false, misleading, or deceptive act or
practice in violation of Section 17.46, Business & Commerce Code.
Sec. 1681.053. CIVIL PENALTY. In addition to requesting a
temporary or permanent injunction against a person or organization
that violates Section 17.46, Business & Commerce Code, as described
by Section 1681.052, the attorney general may request a civil
penalty of not more than $20,000 for each violation.
Sec. 1681.054. REMEDIES NOT EXCLUSIVE. The remedies
provided by this subchapter are:
(1) not exclusive; and
(2) in addition to any other remedy or procedure
provided by another law or at common law.
SECTION 5. This Act takes effect September 1, 2021.