HBA-TYH, ATS H.B. 2049 76(R)BILL ANALYSIS


Office of House Bill AnalysisH.B. 2049
By: Thompson
Insurance
7/7/1999
Enrolled



BACKGROUND AND PURPOSE 

Two provisions in the Insurance Code limit a health insurance carrier's
ability to prevent a person it insures from seeking treatment from
practitioners, other than physicians, who are qualified to treat those
persons within the scope of their practice.  Article 3.70-2(B) (Form of
Policy), Insurance Code, mandates that if an accident and sickness insurer
makes benefits contingent upon treatment of or examination by practitioners
designated by the statute, the insurer's policy must specifically list by
medical classification the included or excluded practitioners.  Article
21.52 (Right to Select Practitioner Under Health and Accident Policies),
Insurance Code, prohibits an accident and health insurer from
discriminating against an insured, with regard to payment or reimbursement,
based on the practitioner chosen by the insured to provide medical care.
The prohibition against discrimination extends to the services of various
practitioners with respect to those services covered by the relevant
insurance policy and within the scope of the practitioner's license or
certification. 

H.B. 2049 includes a licensed acupuncturist in the list of practitioners in
Article 3.70-2(B), V.T.I.C., Article 21.52-1, Insurance Code, and Article
21.52-3, Insurance Code.  This bill also deletes reference to Licensed
Hearing Aid Fitter and Dispenser, Texas Committee of Examiners in the
Fitting and Dispensing of Hearing Instruments, Committee of Examiners for
Speech-Language Pathology and Audiology, and State Board of Insurance, and
replaces them with Licensed Hearing Instrument Fitter and Dispenser, State
Committee of Examiners in the Fitting and Dispensing of Hearing
Instruments, State Board of Examiners for Speech-Language Pathology and
Audiology, and commissioner of insurance, respectively. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that this bill does
not expressly delegate any additional rulemaking authority to a state
officer, department, agency, or institution. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 2(B), Article 3.70-2, V.T.I.C. (Chapter 397,
Acts of the 54th Legislature, Regular Session, 1955), as amended by
Chapters 946 and 1260, Acts of the 75th Legislature, Regular Session, 1997,
to include Licensed Acupuncturist among the medical classifications used to
designate practitioners of the healing arts who will and will not be
recognized by an accident and sickness insurer.  Deletes reference to
Licensed Hearing Aid Fitter and  Dispenser and Texas Committee of Examiners
in the Fitting and Dispensing of Hearing Instruments, and replaces them
with Licensed Hearing Instrument Fitter and Dispenser and State Committee
of Examiners in the Fitting and Dispensing of Hearing Instruments,
respectively.  Defines "Licensed Acupuncturist" to mean one licensed by the
Texas State Board of Medical Examiners as an acupuncturist.  Makes
conforming changes. 

SECTION 2.  Amends Section 1, Article 21.52, Insurance Code, to provide
that a licensed audiologist is a person licensed by the State Board of,
rather than Committee of, Examiners for Speech-Language Pathology and
Audiology in addition to other qualifications and to make conforming
changes. 

SECTION 3.  Amends Section 3, Article 21.52, Insurance Code, as amended by
Chapter 541, Acts of the 74th Legislature, Regular Session, 1995, and as
reenacted and amended by Chapter 946, Acts  of the 75th Legislature,
Regular Session, 1997, to include a licensed acupuncturist to perform the
services or procedures scheduled in a health insurance policy that fall
within the scope of the license of that practitioner, among the
practitioners who may be selected by any person who is issued, who is a
party to, or who is a beneficiary under any health insurance policy.
Deletes reference to the State Board of Insurance, and replaces it with the
commissioner of insurance.  Divides this section into subsections and
subdivisions.  Makes conforming and nonsubstantive changes. 

SECTION 4.  Repealer: Section 3, Article 21.52, Insurance Code, as amended
by Chapter 429, Acts of the 74th Legislature, Regular Session, 1995, and as
reenacted and amended by Chapter 946, Acts of the 75th Legislature, Regular
Session, 1997.   

SECTION 5.Effective date: September 1, 1999.
  Makes application of this Act prospective, as of January 1, 2000.

SECTION 6.Emergency clause.