Bill Text: TX HB3216 | 2017-2018 | 85th Legislature | Introduced
Bill Title: Relating to maintenance of certification by a physician or an applicant for a license to practice medicine in this state.
Spectrum: Partisan Bill (Republican 4-0)
Status: (Introduced - Dead) 2017-03-30 - Referred to Public Health [HB3216 Detail]
Download: Texas-2017-HB3216-Introduced.html
85R6881 BEE-D | ||
By: Bonnen of Galveston | H.B. No. 3216 |
|
||
|
||
relating to maintenance of certification by a physician or an | ||
applicant for a license to practice medicine in this state. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subtitle F, Title 8, Insurance Code, is amended | ||
by adding Chapter 1461 to read as follows: | ||
CHAPTER 1461. DISCRIMINATION AGAINST PHYSICIAN BASED ON | ||
MAINTENANCE OF CERTIFICATION | ||
Sec. 1461.001. DEFINITIONS. In this chapter: | ||
(1) "Enrollee" means an individual who is eligible to | ||
receive health care services under a managed care plan. | ||
(2) "Maintenance of certification" has the meaning | ||
assigned by Section 151.002, Occupations Code. | ||
(3) "Managed care plan" means a health benefit plan | ||
under which medical care services are provided to enrollees through | ||
contracts with physicians and that requires enrollees to use | ||
participating physicians or that provides a different level of | ||
coverage for enrollees who use participating physicians. The term | ||
includes a health benefit plan issued by: | ||
(A) a health maintenance organization; | ||
(B) a preferred provider benefit plan issuer; or | ||
(C) any other entity that issues a health benefit | ||
plan, including an insurance company. | ||
(4) "Participating physician" means a physician who | ||
has directly or indirectly contracted with a health benefit plan | ||
issuer to provide services to enrollees. | ||
(5) "Physician" means a person licensed to practice | ||
medicine in this state. | ||
Sec. 1461.002. APPLICABILITY. (a) This chapter applies to | ||
a physician regardless of whether the physician is a participating | ||
physician. | ||
(b) This chapter applies to a person to whom a managed care | ||
plan issuer contracts to: | ||
(1) process or pay claims; | ||
(2) obtain the services of physicians to provide | ||
medical care services to enrollees; or | ||
(3) issue verifications or preauthorizations. | ||
Sec. 1461.003. DISCRIMINATION BASED ON MAINTENANCE OF | ||
CERTIFICATION. A managed care plan issuer may not differentiate | ||
between physicians based solely on a physician's maintenance of | ||
certification in regard to: | ||
(1) paying the physician; | ||
(2) reimbursing the physician; or | ||
(3) directly or indirectly contracting with the | ||
physician to provide services to enrollees. | ||
SECTION 2. Section 151.002(a), Occupations Code, is amended | ||
by adding Subdivision (6-b) to read as follows: | ||
(6-b) "Maintenance of certification" means the | ||
satisfactory completion of periodic recertification examinations | ||
required to maintain certification after an initial certification | ||
under a medical specialty member board, including the member boards | ||
of the American Board of Medical Specialties or the specialty | ||
certifying boards of the American Osteopathic Association. | ||
SECTION 3. Subchapter B, Chapter 151, Occupations Code, is | ||
amended by adding Section 151.0515 to read as follows: | ||
Sec. 151.0515. DISCRIMINATION BASED ON MAINTENANCE OF | ||
CERTIFICATION. A hospital, institution, or program that is | ||
licensed by this state, is operated by this state or a political | ||
subdivision of this state, or directly or indirectly receives state | ||
financial assistance may not differentiate between physicians | ||
based solely on a physician's maintenance of certification. | ||
SECTION 4. Section 155.003, Occupations Code, is amended by | ||
amending Subsection (d) and adding Subsection (d-1) to read as | ||
follows: | ||
(d) Except as provided by Subsection (d-1), in [ |
||
to the other requirements prescribed by this subtitle, the board | ||
may require an applicant to comply with other requirements that the | ||
board considers appropriate. | ||
(d-1) The board may not require maintenance of | ||
certification by an applicant for the applicant to be eligible for a | ||
license under this chapter. | ||
SECTION 5. Section 156.001, Occupations Code, is amended by | ||
adding Subsection (f) to read as follows: | ||
(f) The board may not adopt a rule requiring maintenance of | ||
certification by a license holder for the license holder to be | ||
eligible for an initial or renewal registration permit. | ||
SECTION 6. This Act takes effect September 1, 2017. |