HBA-TYH, ATS C.S.H.B. 2049 76(R)BILL ANALYSIS Office of House Bill AnalysisC.S.H.B. 2049 By: Thompson Insurance 4/23/1999 Committee Report (Substituted) 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. C.S.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 makes changes to the 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. COMPARISON OF ORIGINAL TO SUBSTITUTE The substitute modifies the original bill by changing the caption from "relating to the recognition of particular practitioners under a policy of health and accident insurance and the selection of a practitioners by a beneficiary under a health insurance policy" to "relating to the right of a person entitled to coverage under certain health and accident insurance policies to select certain health care practitioners"and making changes to conform with Legislative Council format throughout the bill. The substitute modifies the original bill by adding SECTIONS 2 and 4, and redesignating SECTIONS 2, 3 (effective date), and 4 (emergency clause) of the original to SECTIONS 3, 5, and 6, respectively. The substitute also modifies the original bill, as follows: SECTION 1. Amends Section 2(B), Article 3.70-2, V.T.I.C., to delete reference to "Doctor of Oriental Medicine." 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, rather than one licensed by the Board of Medical Examiners. SECTION 2. Amends Section 1, Article 21.52, Insurance Code, to provide that a licensed audiologist is a person licensed by the State Board, rather than Committee of Examiners for SpeechLanguage 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 delete reference to the State Board of Insurance, and replace 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. Provides that the effective date of this Act is September 1, 1999 and that application of this Act is prospective, as of January 1, 2000. The original bill only provided that the effective date is September 1, 1999. SECTION 6. Sets forth the short emergency clause. The original bill sets forth the long emergency clause.