HBA-JEK C.S.H.B. 2620 77(R)BILL ANALYSIS


Office of House Bill AnalysisC.S.H.B. 2620
By: Goodman
Insurance
4/26/2001
Committee Report (Substituted)



BACKGROUND AND PURPOSE 

Managed care organizations require physicians and patients to complete
large amounts of paperwork. Increasing administrative costs are a possible
factor in rising health care costs, and administrative duties detract from
the time physicians are able to spend with their patients.  Most managed
care organizations ask for the same information, but they often place the
information in a different format and require physicians to use the
organization's specific forms.  The absence of standardized forms can delay
care and inconvenience patients and physicians.  C.S.H.B. 2620 provides for
the use of standard physician contracts and forms for those contracts. 

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 1 (Article 21.52K, Insurance Code) and SECTION 2 of this bill. 

ANALYSIS

C.S.H.B. 2620 amends the Insurance Code to require the commissioner of
insurance (commissioner) to adopt rules that establish and require managed
care entities to use standard physician contracts and forms for those
contracts.  The bill requires the commissioner to adopt the rules,
contracts, and forms by January 1, 2002. 

EFFECTIVE DATE

September 1, 2001.

COMPARISON OF ORIGINAL TO SUBSTITUTE

C.S.H.B. 2620 differs from the original bill by removing the requirement
that the commissioner of insurance adopt rules to establish and require
managed care entities to use other standard documents and forms for routine
managed care functions other than those for contracts.  The substitute
removes the provision that the commissioner's rules must include standard
documents for member identification cards, referral forms, and
pre-authorization forms.   

The substitute also removes the provision that applied this bill to a
multiple employer welfare arrangement or analogous benefit arrangement and
any non-licensed entity that contracts directly for health care services on
a risk-sharing basis.