Bill Text: TX HB3218 | 2017-2018 | 85th Legislature | Enrolled
Bill Title: Relating to health maintenance organization contracts with certain entities to provide health care services.
Spectrum: Partisan Bill (Republican 2-0)
Status: (Passed) 2017-06-01 - Effective on 9/1/17 [HB3218 Detail]
Download: Texas-2017-HB3218-Enrolled.html
H.B. No. 3218 |
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relating to health maintenance organization contracts with certain | ||
entities to provide health care services. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 843.101, Insurance Code, is amended by | ||
amending Subsection (b) and adding Subsections (b-1) and (b-2) to | ||
read as follows: | ||
(b) A health maintenance organization may provide or | ||
arrange for health care services only through: | ||
(1) other health maintenance organizations; | ||
(2) providers or groups of providers who are: | ||
(A) under contract with or are employed by the | ||
health maintenance organization; or | ||
(B) under contract with an entity that is under | ||
contract with the health maintenance organization to provide a | ||
network of providers to provide health care services only if the | ||
contract between the entity and the health maintenance | ||
organization: | ||
(i) does not limit the health maintenance | ||
organization's authority or responsibility, including financial | ||
responsibility, to comply with any regulatory requirement that | ||
applies to a function performed by the entity; | ||
(ii) requires the entity to comply with all | ||
regulatory requirements that apply to a function performed by the | ||
entity; and | ||
(iii) expressly sets forth the requirements | ||
of Subparagraphs (i) and (ii); or | ||
(3) additional health maintenance organizations or | ||
physicians or providers who have contracted for health care | ||
services with: | ||
(A) the other health maintenance organizations; | ||
(B) physicians with whom the health maintenance | ||
organization has contracted; or | ||
(C) providers who are under contract with or are | ||
employed by the health maintenance organization. | ||
(b-1) Except as provided by Subsection (b-2) and | ||
notwithstanding any other law, an entity described by Subsection | ||
(b)(2)(B) and the health maintenance organization with which the | ||
entity contracts are subject to Chapter 1272 as if the entity were a | ||
delegated entity unless the entity: | ||
(1) is a delegated network or delegated third party as | ||
defined by Section 1272.001; or | ||
(2) is not a delegated entity as provided by Section | ||
1272.001(a)(1)(A) or (B). | ||
(b-2) An entity subject to Chapter 1272 under Subsection | ||
(b-1) that does not assume risk and the health maintenance | ||
organization with which the entity contracts are not subject to the | ||
following provisions: | ||
(1) Section 1272.053(1); | ||
(2) Section 1272.057(1); | ||
(3) Section 1272.061(1)(C); and | ||
(4) Subchapter D, Chapter 1272. | ||
SECTION 2. This Act takes effect September 1, 2017. | ||
______________________________ | ______________________________ | |
President of the Senate | Speaker of the House | |
I certify that H.B. No. 3218 was passed by the House on May 8, | ||
2017, by the following vote: Yeas 143, Nays 0, 1 present, not | ||
voting. | ||
______________________________ | ||
Chief Clerk of the House | ||
I certify that H.B. No. 3218 was passed by the Senate on May | ||
23, 2017, by the following vote: Yeas 31, Nays 0. | ||
______________________________ | ||
Secretary of the Senate | ||
APPROVED: _____________________ | ||
Date | ||
_____________________ | ||
Governor |