HBA-NMO H.B. 1194 76(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 1194
By: Turner, Bob
Insurance
3/2/99
Introduced



BACKGROUND AND PURPOSE 

The 75th Texas Legislature enacted legislation creating the statewide rural
health care system.  The system provides  rural communities an alternative
to urban-based Health Maintenance Organizations now operating in rural
Texas. However, certain changes may be necessary to improve the
implementation of the system.  H.B. 1194 requires the Commissioner of
Insurance (commissioner) to consider certain criteria in designating rural
areas for the purposes of the system, and amends language regarding prepaid
health care services.  This bill also authorizes the commissioner, by rule,
to provide exceptions to the application of the Texas Health Maintenance
Organization Act, and makes changes regarding the board of directors of the
system and the advisory committee appointed by the board.  

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that rulemaking
authority is expressly delegated to the Commissioner of Insurance in
SECTION 3 (Article 20C.04, Insurance Code) of this bill.  

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Article 20C.02, Insurance Code, as follows:

(a) Creates from existing text.  Provides that the rules adopted by the
Commissioner of Insurance (commissioner) used to designate rural areas are
subject to Subsection (b). 

(b) Requires the commissioner, in designating rural areas under Subsection
(a), to consider any area in which appropriate emergency, acute, specialty,
or primary care services are limited or unavailable and could be made more
accessible through contracting with the statewide rural health care system
(system) or a participating community health network, or any area the
demographics of which indicate a high population of aged, atrisk, or
low-income persons, including persons with serious mental illness or
serious emotional disturbance, whose needs would be better served by
allowing access to care in a contiguous area that is eligible to
participate in the system. 

SECTION 2.  Amends Article 20C.03, Insurance Code, to provide that the
system is established to arrange for or provide health care services,
including services on a prepaid basis, rather than  health care services on
a prepaid basis, to enrollees who reside in rural areas. 

SECTION 3.  Amends Article 20C.04, Insurance Code, to authorize the
commissioner, by rule, to provide exceptions to the application of the
Texas Health Maintenance Organization Act (Chapter 20A, Insurance Code) to
accommodate the special circumstances surrounding the system and its
participating service areas designated as rural areas.  Redesignates
existing Subsection (b) to Subsection (c). 

SECTION 4.  Amends Article 20C.07(a), Insurance Code, to provide that the
members of the board of the statewide rural health care system (board)
serve staggered six-year terms, with the terms of six members expiring
December 1 of each even-numbered year, rather than February 1 of each odd
numbered year. 

 SECTION 5.  Amends Article 20C.08(f), Insurance Code, to authorize the
board to appoint an advisory committee to represent health care services,
including representatives of rural, urban, and educational groups and
organizations.  Requires the advisory committee to meet at the will of the
board and advise the board on any matters as directed by the board.
Deletes language referring to the required composition of the advisory
committee. 

SECTION 6.  Effective date: September 1, 1999.  Provides that the term of a
member of the board of directors of the statewide rural health care system
appointed before the effective date of  this Act expires December 1 of the
year before the year the term was to expire under Chapter 20C, Insurance
Code, as that chapter existed before amendment by this Act.  

SECTION 7.  Emergency clause.