Bill Text: TX HB1864 | 2011-2012 | 82nd Legislature | Comm Sub
Bill Title: Relating to a prohibition on the coercion of therapeutic optometrists and ophthalmologists by managed care plans.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2011-04-21 - Committee report sent to Calendars [HB1864 Detail]
Download: Texas-2011-HB1864-Comm_Sub.html
82R8992 TRH-F | ||
By: Smithee, Eiland | H.B. No. 1864 |
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relating to a prohibition on the coercion of therapeutic | ||
optometrists and ophthalmologists by managed care plans. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 1451.153, Insurance Code, is amended by | ||
amending Subsection (a) and adding Subsection (c) to read as | ||
follows: | ||
(a) A managed care plan may not: | ||
(1) discriminate against a health care practitioner | ||
because the practitioner is an optometrist, therapeutic | ||
optometrist, or ophthalmologist; | ||
(2) restrict or discourage a plan participant from | ||
obtaining covered vision or medical eye care services or procedures | ||
from a participating optometrist, therapeutic optometrist, or | ||
ophthalmologist solely because the practitioner is an optometrist, | ||
therapeutic optometrist, or ophthalmologist; | ||
(3) exclude an optometrist, therapeutic optometrist, | ||
or ophthalmologist as a participating practitioner in the plan | ||
because the optometrist, therapeutic optometrist, or | ||
ophthalmologist does not have medical staff privileges at a | ||
hospital or at a particular hospital; [ |
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(4) exclude an optometrist, therapeutic optometrist, | ||
or ophthalmologist as a participating practitioner in the plan | ||
because the services or procedures provided by the optometrist, | ||
therapeutic optometrist, or ophthalmologist may be provided by | ||
another type of health care practitioner; or | ||
(5) as a condition for a therapeutic optometrist or | ||
ophthalmologist to be included in one or more of the plan's medical | ||
panels, require the therapeutic optometrist or ophthalmologist to | ||
be included in, or to accept the terms of payment under or for, a | ||
particular vision panel in which the therapeutic optometrist or | ||
ophthalmologist does not otherwise wish to be included. | ||
(c) For the purposes of Subsection (a)(5), "medical panel" | ||
and "vision panel" have the meanings assigned by Section | ||
1451.154(a). | ||
SECTION 2. The change in law made by this Act applies only | ||
to a contract entered into or renewed by a therapeutic optometrist | ||
or ophthalmologist and an issuer of a managed care plan on or after | ||
January 1, 2012. A contract entered into or renewed before January | ||
1, 2012 is governed by the law in effect immediately before the | ||
effective date of this Act, and that law is continued in effect for | ||
that purpose. | ||
SECTION 3. This Act takes effect September 1, 2011. |