Bill Text: TX SB1037 | 2021-2022 | 87th Legislature | Introduced
Bill Title: Relating to the definition of emergency care for purposes of certain health benefit plans.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2021-03-18 - Referred to Business & Commerce [SB1037 Detail]
Download: Texas-2021-SB1037-Introduced.html
87R6443 MWC-F | ||
By: Whitmire | S.B. No. 1037 |
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relating to the definition of emergency care for purposes of | ||
certain health benefit plans. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 843.002(7), Insurance Code, is amended | ||
to read as follows: | ||
(7) "Emergency care" means health care services | ||
provided in a hospital emergency facility, freestanding emergency | ||
medical care facility, or comparable emergency facility to evaluate | ||
and stabilize medical conditions of a recent onset and severity, | ||
including severe pain, regardless of the final diagnosis of the | ||
conditions, that would lead a prudent layperson possessing an | ||
average knowledge of medicine and health to believe that the | ||
individual's condition, sickness, or injury is of such a nature | ||
that failure to get immediate medical care could: | ||
(A) place the individual's health in serious | ||
jeopardy; | ||
(B) result in serious impairment to bodily | ||
functions; | ||
(C) result in serious dysfunction of a bodily | ||
organ or part; | ||
(D) result in serious disfigurement; or | ||
(E) for a pregnant woman, result in serious | ||
jeopardy to the health of the fetus. | ||
SECTION 2. Section 1301.155(a), Insurance Code, is amended | ||
to read as follows: | ||
(a) In this section, "emergency care" means health care | ||
services provided in a hospital emergency facility, freestanding | ||
emergency medical care facility, or comparable emergency facility | ||
to evaluate and stabilize a medical condition of a recent onset and | ||
severity, including severe pain, regardless of the final diagnosis | ||
of the condition, that would lead a prudent layperson possessing an | ||
average knowledge of medicine and health to believe that the | ||
person's condition, sickness, or injury is of such a nature that | ||
failure to get immediate medical care could result in: | ||
(1) placing the person's health in serious jeopardy; | ||
(2) serious impairment to bodily functions; | ||
(3) serious dysfunction of a bodily organ or part; | ||
(4) serious disfigurement; or | ||
(5) in the case of a pregnant woman, serious jeopardy | ||
to the health of the fetus. | ||
SECTION 3. Section 4201.002(2), Insurance Code, is amended | ||
to read as follows: | ||
(2) "Emergency care" means health care services | ||
provided in a hospital emergency facility or comparable facility to | ||
evaluate and stabilize medical conditions of a recent onset and | ||
severity, including severe pain, regardless of the final diagnosis | ||
of the conditions, that would lead a prudent layperson possessing | ||
an average knowledge of medicine and health to believe that the | ||
individual's condition, sickness, or injury is of such a nature | ||
that failure to get immediate medical care could: | ||
(A) place the individual's health in serious | ||
jeopardy; | ||
(B) result in serious impairment to bodily | ||
functions; | ||
(C) result in serious dysfunction of a bodily | ||
organ or part; | ||
(D) result in serious disfigurement; or | ||
(E) for a pregnant woman, result in serious | ||
jeopardy to the health of the fetus. | ||
SECTION 4. The changes in law made by this Act apply only to | ||
a health benefit plan delivered, issued for delivery, or renewed on | ||
or after January 1, 2022. A health benefit plan delivered, issued | ||
for delivery, or renewed before January 1, 2022, 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 5. This Act takes effect September 1, 2021. |