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A BILL TO BE ENTITLED
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AN ACT
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relating to payment for health care services and participation in a |
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health care system. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Title 8, Insurance Code, is amended by adding |
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Subtitle K to read as follows: |
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SUBTITLE K. PROVISIONS APPLICABLE TO HEALTH CARE SERVICES PROVIDED |
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PURSUANT TO HEALTH CARE SYSTEM |
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CHAPTER 1671. HEALTH CARE SERVICES PROVIDED PURSUANT TO HEALTH |
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CARE SYSTEM |
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Sec. 1671.001. DEFINITIONS. In this chapter: |
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(1) "Direct payment" means payment for health care |
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services provided to an individual or a dependent of the individual |
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that is made by the individual or by the individual's employer, |
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without a public or private third party, other than the employer, |
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paying for any portion of the service. |
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(2) "Health care system" means any public or private |
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entity, including a health insurer or health benefit plan, that for |
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the benefit of its participants: |
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(A) manages, enrolls individuals in, or makes |
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full or partial payment for health care services; or |
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(B) manages or processes health care data or |
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information. |
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Sec. 1671.002. DIRECT PAYMENT; HEALTH CARE SYSTEM |
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PARTICIPATION. (a) This state, an agency of this state, or a health |
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care system may not: |
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(1) impose a fine or penalty on an individual or the |
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individual's employer for direct payment for a health care service; |
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(2) impose a fine or penalty on a health care provider |
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for accepting direct payment for a health care service; or |
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(3) directly or indirectly require an individual, |
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employer, or health care provider to participate in a health care |
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system, including imposing a fine or penalty for failure to |
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participate. |
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(b) This section does not: |
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(1) affect which health care services a health care |
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provider or hospital is required to provide; |
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(2) affect which health care services are permitted by |
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law; |
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(3) prohibit care provided pursuant to a workers' |
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compensation claim; |
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(4) affect a law or rule in effect January 1, 2010; or |
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(5) affect the terms or conditions of a health care |
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system that do not: |
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(A) impose a fine or penalty on an individual or |
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the individual's employer for direct payment for a health care |
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service; or |
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(B) impose a fine or penalty on a health care |
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provider for accepting direct payment for a health care service. |
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Sec. 1671.003. CONFLICTING LAW. A law that conflicts with |
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this chapter is void. |
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SECTION 2. This Act takes effect September 1, 2011. |