Bill Text: TX HB2630 | 2019-2020 | 86th Legislature | Engrossed

Texas House Bill 2630 (Prior Session Legislation)

Bill Title: Relating to physician and health care provider directories for certain health benefit plans.

Sponsorship: Partisan Bill (Democrat 1)

Status: (Engrossed - Dead) 2019-04-29 - Referred to Business & Commerce [HB2630 Detail]

Download: Texas-2019-HB2630-Engrossed.html



	By: J. Johnson of Dallas	H.B. No. 2630



	A BILL TO BE ENTITLED
	AN ACT
	relating to physician and health care provider directories for
	certain health benefit plans.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1. Section 1451.501, Insurance Code, is amended by
	amending Subdivision (1) and adding Subdivisions (1-a) and (1-b) to
	read as follows:
	(1) "Facility" has the meaning assigned by Section
	324.001, Health and Safety Code.
	(1-a) "Facility-based physician" means a radiologist,
	anesthesiologist, pathologist, emergency department physician,
	neonatologist, or assistant surgeon:
	(A) to whom a facility has granted clinical
	privileges; and
	(B) who provides services to patients of the
	facility under those clinical privileges.
	(1-b) "Health care provider" means a practitioner,
	institutional provider, or other person or organization that
	furnishes health care services and that is licensed or otherwise
	authorized to practice in this state. The term includes a
	pharmacist, pharmacy, hospital, nursing home, or other medical or
	health-related service facility that provides care for the sick or
	injured or other care. The term does not include a physician.
	SECTION 2. Section 1451.504, Insurance Code, is amended by
	amending Subsection (b) and adding Subsections (c) and (d) to read
	as follows:
	(b) The directory must include the name, street address,
	specialty, if any, and telephone number of each physician and
	health care provider described by Subsection (a) and indicate
	whether the physician or provider is accepting new patients.
	(c) For each health care provider that is a facility
	included in the directory under this section, the directory must:
	(1) list under the facility name separate headings for
	radiologists, anesthesiologists, pathologists, emergency
	department physicians, neonatologists, and assistant surgeons;
	(2) list under each heading described by Subdivision
	(1) each facility-based physician described by Subsection (a)
	practicing in the specialty corresponding with that heading that is
	a preferred provider, exclusive provider, or network physician;
	(3) for the facility and each facility-based physician
	described by Subdivision (2), clearly indicate each health benefit
	plan issued by the issuer that may provide coverage for the services
	provided by that facility or physician; and
	(4) include the facility in a listing of all
	facilities included in the directory indicating:
	(A) the name of the facility;
	(B) the municipality in which the facility is
	located or county in which the facility is located if the facility
	is in the unincorporated area of the county;
	(C) for each specialty of facility-based
	physician practicing at the facility, the name, street address, and
	telephone number of any facility-based physician that is a
	preferred provider, exclusive provider, or network physician or of
	the physician group in which the facility-based physician
	practices;
	(D) each health benefit plan issued by the issuer
	that may provide coverage for the services provided by the
	facility; and
	(E) each health benefit plan issued by the issuer
	that may provide coverage for the services provided by each
	facility-based physician group.
	(d) The directory must list a facility-based physician
	individually and, if the physician belongs to a physician group, as
	part of the physician group.
	SECTION 3. Section 1451.505(c), Insurance Code, is amended
	to read as follows:
	(c) The directory must be:
	(1) electronically searchable by physician or health
	care provider name, specialty, if any, and location; and
	(2) publicly accessible without necessity of
	providing a password, a user name, or personally identifiable
	information.
	SECTION 4. A health benefit plan issuer shall update the
	issuer's website to conform with Subchapter K, Chapter 1451,
	Insurance Code, as amended by this Act, not later than January 1,
	2020.
	SECTION 5. This Act takes effect September 1, 2019.