Bill Text: TX HB2348 | 2015-2016 | 84th Legislature | Introduced
Bill Title: Relating to nondiscrimination against physicians in payment for telephone consultation services.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2015-05-14 - Placed on General State Calendar [HB2348 Detail]
Download: Texas-2015-HB2348-Introduced.html
84R11355 SCL-F | ||
By: Price | H.B. No. 2348 |
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relating to nondiscrimination against physicians in payment for | ||
telephone consultation services. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subtitle F, Title 8, Insurance Code, is amended | ||
by adding Chapter 1459 to read as follows: | ||
CHAPTER 1459. FAIR ACCESS TO TELEPHONE CONSULTATIONS | ||
Sec. 1459.001. DEFINITION. In this chapter, "physician" | ||
means: | ||
(1) an individual licensed to practice medicine in | ||
this state under Subtitle B, Title 3, Occupations Code; | ||
(2) a professional association composed solely of | ||
individuals licensed to practice medicine in this state; | ||
(3) a single legal entity authorized to practice | ||
medicine in this state that is owned by a group of individuals | ||
licensed to practice medicine in this state; | ||
(4) a nonprofit health corporation certified by the | ||
Texas Medical Board under Chapter 162, Occupations Code; or | ||
(5) a partnership composed solely of individuals | ||
licensed to practice medicine in this state. | ||
Sec. 1459.002. APPLICABILITY OF CHAPTER. (a) This chapter | ||
applies only to an employee benefit plan or a health benefit plan | ||
that provides benefits for medical or surgical expenses incurred as | ||
a result of a health condition, accident, or sickness, including: | ||
(1) an individual, group, blanket, or franchise | ||
insurance policy or insurance agreement, a group hospital service | ||
contract, or a small or large employer group contract or similar | ||
coverage document that is offered by: | ||
(A) an insurance company; | ||
(B) a group hospital service corporation | ||
operating under Chapter 842; | ||
(C) a fraternal benefit society operating under | ||
Chapter 885; | ||
(D) a stipulated premium company operating under | ||
Chapter 884; | ||
(E) a reciprocal exchange operating under | ||
Chapter 942; | ||
(F) a health maintenance organization operating | ||
under Chapter 843; or | ||
(G) an approved nonprofit health corporation | ||
that holds a certificate of authority under Chapter 844; or | ||
(2) a multiple employer welfare arrangement that holds | ||
a certificate of authority under Chapter 846, or any other employee | ||
benefit plan. | ||
(b) This chapter applies to group health coverage made | ||
available by a school district in accordance with Section 22.004, | ||
Education Code. | ||
(c) Notwithstanding Section 172.014, Local Government Code, | ||
or any other law, this chapter applies to health and accident | ||
coverage provided by a risk pool created under Chapter 172, Local | ||
Government Code. | ||
(d) Notwithstanding any provision in Chapter 1551, 1575, | ||
1579, or 1601 or any other law, this chapter applies to: | ||
(1) a basic coverage plan under Chapter 1551; | ||
(2) a basic plan under Chapter 1575; | ||
(3) a primary care coverage plan under Chapter 1579; | ||
and | ||
(4) basic coverage under Chapter 1601. | ||
(e) Notwithstanding Section 1501.251 or any other law, this | ||
chapter applies to a small employer health benefit plan subject to | ||
Chapter 1501. | ||
(f) Notwithstanding Sections 1507.004 and 1507.053, or any | ||
other law, this chapter applies to a consumer choice of benefits | ||
plan issued under Chapter 1507. | ||
(g) Notwithstanding any other law, this chapter applies to: | ||
(1) the state child health plan or the health benefits | ||
plan for children under Chapter 62 or 63, Health and Safety Code; | ||
(2) a Medicaid managed care program operated under | ||
Chapter 533, Government Code; and | ||
(3) a Medicaid program operated under Chapter 32, | ||
Human Resources Code. | ||
Sec. 1459.003. NONDISCRIMINATION IN TELEPHONE CONSULTATION | ||
SERVICES. (a) An employee benefit plan or a health benefit plan | ||
may not: | ||
(1) prohibit a physician from charging for a telephone | ||
consultation with a covered patient if that plan allows another | ||
person to charge for a telephone consultation with a covered | ||
patient; | ||
(2) deny payment to a physician for a medically | ||
necessary telephone consultation with a covered patient if that | ||
plan pays another person for a telephone consultation with a | ||
covered patient; or | ||
(3) discriminate against a physician in determining a | ||
payment amount for a medically necessary telephone consultation | ||
provided to a covered patient if that plan pays another person for a | ||
telephone consultation with a covered patient. | ||
(b) Nothing in this section shall be construed as | ||
prohibiting an employee benefit plan or a health benefit plan from | ||
paying a physician for medically necessary telephone | ||
consultations. | ||
(c) Nothing in this section shall be construed as permitting | ||
a physician to charge or requiring an employee benefit plan or a | ||
health benefit plan to pay for telephonic: | ||
(1) appointment scheduling; | ||
(2) appointment reminders; or | ||
(3) responses to billing or payment inquiries. | ||
SECTION 2. The change in law made by this Act applies only | ||
to an employee benefit plan or a health benefit plan that is | ||
delivered, issued for delivery, or renewed on or after September 1, | ||
2015. An employee benefit plan or a health benefit plan delivered, | ||
issued for delivery, or renewed before September 1, 2015, is | ||
governed by the law as it existed immediately before the effective | ||
date of this Act, and that law is continued in effect for that | ||
purpose. | ||
SECTION 3. If before implementing any provision of this Act | ||
a state agency determines that a waiver or authorization from a | ||
federal agency is necessary for implementation of that provision, | ||
the agency affected by the provision shall request the waiver or | ||
authorization and may delay implementing that provision until the | ||
waiver or authorization is granted. | ||
SECTION 4. This Act takes effect September 1, 2015. |