87R4862 SCL-F
 
  By: Campbell S.B. No. 1442
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to regulation of health care sharing ministries; providing
  civil penalties.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Chapter 1681, Insurance Code, is amended by
  designating Sections 1681.001 through 1681.003 as Subchapter A and
  adding a subchapter heading to read as follows:
  SUBCHAPTER A. HEALTH CARE SHARING MINISTRY REQUIREMENTS
         SECTION 2.  Sections 1681.001 and 1681.002, Insurance Code,
  are amended to read as follows:
         Sec. 1681.001.  TREATMENT AS HEALTH CARE SHARING MINISTRY.
  A faith-based, nonprofit organization that is tax-exempt under the
  Internal Revenue Code of 1986 qualifies for treatment as a health
  care sharing ministry under this chapter if it:
               (1)  limits its participants to individuals of a
  similar faith;
               (2)  acts as a facilitator among participants who have
  medical expenses [bills] and matches those participants with other
  participants [with the present ability] to assist those with
  medical expenses [bills] in accordance with criteria established by
  the health care sharing ministry;
               (3)  provides for the satisfaction of the medical
  expenses [bills] of a participant through contributions from one
  participant to another, including through collected contributions
  or from participant contributions collected by the health care
  sharing ministry;
               (4)  provides amounts that participants may contribute
  with no assumption of risk or promise to pay among the participants
  and no assumption of risk or promise to pay by the health care
  sharing ministry to the participants;
               (5)  provides a [written] monthly statement to all
  participants that lists the total dollar amount of qualified
  eligible sharing requests [needs] submitted to the health care
  sharing ministry, as well as the amount actually shared with
  [published or assigned to] participants for their contribution;
               (6)  discloses administrative fees and costs to
  participants;
               (7)  provides that any card issued to a participant for
  the purpose of presentation to a health care provider clearly
  indicates that the participant is part of a health care sharing
  ministry that is not engaging in the business of insurance;
               (8)  provides a written disclaimer on or accompanying
  all applications and guideline materials distributed by or on
  behalf of the ministry that complies with Section 1681.002; [and]
               (9)  does not operate a discount health care program as
  defined by Section 7001.001;
               (10)  is exempt from federal taxation under 26 U.S.C.
  Section 501(a) by being described by Section 501(c)(3) of that
  code;
               (11)  ensures that a participant retains membership
  regardless of whether the participant develops a medical condition;
               (12)  has been or a predecessor of the health care
  sharing ministry has been in existence at all times since December
  31, 1999, and medical expenses of its participants have been shared
  continuously and without interruption since at least December 31,
  1999;
               (13)  performs an annual audit that is:
                     (A)  conducted by an independent certified public
  accounting firm in accordance with generally accepted accounting
  principles; and
                     (B)  made available to the public on request; and
               (14)  has received a written confirmation from the
  Centers for Medicare and Medicaid Services that verifies that the
  health care sharing ministry satisfies federal qualifications for a
  health care sharing ministry.
         Sec. 1681.002.  NOTICE. To qualify as a health care sharing
  ministry under this chapter, the notice described by Section
  1681.001(8) must read substantially as follows:
         "Notice: This health care sharing ministry facilitates the
  sharing of medical expenses and is not an insurance company, and
  neither its guidelines nor its plan of operation is an insurance
  policy. Whether anyone chooses to assist you with your medical
  expenses [bills] will be totally voluntary because no other
  participant will be compelled by law to contribute toward your
  medical expenses [bills]. As such, participation in the ministry or
  a subscription to any of its documents should never be considered to
  be insurance. Regardless of whether you receive any payment for
  medical expenses, whether any payment is made to a health care
  provider on your behalf from collected contributions, or whether
  this ministry continues to operate, you are always personally
  responsible for the payment of your own medical expenses [bills].
  Complaints concerning this health care sharing ministry may be
  reported to the office of the Texas attorney general."
         SECTION 3.  Subchapter A, Chapter 1681, Insurance Code, as
  added by this Act, is amended by adding Section 1681.004 to read as
  follows:
         Sec. 1681.004.  CONTRACTING AUTHORITY. A health care
  sharing ministry may:
               (1)  contract and negotiate with health care providers
  and provider networks for the purpose of lowering medical expenses
  for sharing among members; and
               (2)  contract with a discount health care program
  registered in this state to provide participants with access to
  discounts on health care services provided by health care providers
  if the health care sharing ministry does not act as a program
  operator as defined by Section 7001.001.
         SECTION 4.  Chapter 1681, Insurance Code, is amended by
  adding Subchapter B to read as follows:
  SUBCHAPTER B. ENFORCEMENT
         Sec. 1681.051.  ATTORNEY GENERAL JURISDICTION. The attorney
  general has:
               (1)  the exclusive authority to determine whether an
  organization qualifies for treatment as a health care sharing
  ministry under this chapter; and
               (2)  exclusive jurisdiction and enforcement authority
  over all complaints and compliance issues concerning health care
  sharing ministries.
         Sec. 1681.052.  DECEPTIVE TRADE PRACTICE. A person or
  organization that operates a health care sharing ministry that is
  not qualified as a health care sharing ministry under this chapter
  is considered to engage in a false, misleading, or deceptive act or
  practice in violation of Section 17.46, Business & Commerce Code. 
         Sec. 1681.053.  CIVIL PENALTY. In addition to requesting a
  temporary or permanent injunction against a person or organization
  that violates Section 17.46, Business & Commerce Code, as described
  by Section 1681.052, the attorney general may request a civil
  penalty of not more than $20,000 for each violation.
         Sec. 1681.054.  REMEDIES NOT EXCLUSIVE. The remedies
  provided by this subchapter are:
               (1)  not exclusive; and
               (2)  in addition to any other remedy or procedure
  provided by another law or at common law.
         SECTION 5.  This Act takes effect September 1, 2021.