84R11355 SCL-F
	By: Price	H.B. No. 2348

	A BILL TO BE ENTITLED
	AN ACT
	relating to nondiscrimination against physicians in payment for
	telephone consultation services.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Subtitle F, Title 8, Insurance Code, is amended
	by adding Chapter 1459 to read as follows:
	CHAPTER 1459. FAIR ACCESS TO TELEPHONE CONSULTATIONS
	Sec. 1459.001.  DEFINITION. In this chapter, "physician"
	means:
	(1)  an individual licensed to practice medicine in
	this state under Subtitle B, Title 3, Occupations Code;
	(2)  a professional association composed solely of
	individuals licensed to practice medicine in this state;
	(3)  a single legal entity authorized to practice
	medicine in this state that is owned by a group of individuals
	licensed to practice medicine in this state;
	(4)  a nonprofit health corporation certified by the
	Texas Medical Board under Chapter 162, Occupations Code; or
	(5)  a partnership composed solely of individuals
	licensed to practice medicine in this state.
	Sec. 1459.002.  APPLICABILITY OF CHAPTER.  (a)  This chapter
	applies only to an employee benefit plan or a health benefit plan
	that provides benefits for medical or surgical expenses incurred as
	a result of a health condition, accident, or sickness, including:
	(1)  an individual, group, blanket, or franchise
	insurance policy or insurance agreement, a group hospital service
	contract, or a small or large employer group contract or similar
	coverage document that is offered by:
	(A)  an insurance company;
	(B)  a group hospital service corporation
	operating under Chapter 842;
	(C)  a fraternal benefit society operating under
	Chapter 885;
	(D)  a stipulated premium company operating under
	Chapter 884;
	(E)  a reciprocal exchange operating under
	Chapter 942;
	(F)  a health maintenance organization operating
	under Chapter 843; or
	(G)  an approved nonprofit health corporation
	that holds a certificate of authority under Chapter 844; or
	(2)  a multiple employer welfare arrangement that holds
	a certificate of authority under Chapter 846, or any other employee
	benefit plan.
	(b)  This chapter applies to group health coverage made
	available by a school district in accordance with Section 22.004,
	Education Code.
	(c)  Notwithstanding Section 172.014, Local Government Code,
	or any other law, this chapter applies to health and accident
	coverage provided by a risk pool created under Chapter 172, Local
	Government Code.
	(d)  Notwithstanding any provision in Chapter 1551, 1575,
	1579, or 1601 or any other law, this chapter applies to:
	(1)  a basic coverage plan under Chapter 1551;
	(2)  a basic plan under Chapter 1575;
	(3)  a primary care coverage plan under Chapter 1579;
	and
	(4)  basic coverage under Chapter 1601.
	(e)  Notwithstanding Section 1501.251 or any other law, this
	chapter applies to a small employer health benefit plan subject to
	Chapter 1501.
	(f)  Notwithstanding Sections 1507.004 and 1507.053, or any
	other law, this chapter applies to a consumer choice of benefits
	plan issued under Chapter 1507.
	(g)  Notwithstanding any other law, this chapter applies to:
	(1)  the state child health plan or the health benefits
	plan for children under Chapter 62 or 63, Health and Safety Code;
	(2)  a Medicaid managed care program operated under
	Chapter 533, Government Code; and
	(3)  a Medicaid program operated under Chapter 32,
	Human Resources Code.
	Sec. 1459.003.  NONDISCRIMINATION IN TELEPHONE CONSULTATION
	SERVICES. (a)  An employee benefit plan or a health benefit plan
	may not:
	(1)  prohibit a physician from charging for a telephone
	consultation with a covered patient if that plan allows another
	person to charge for a telephone consultation with a covered
	patient;
	(2)  deny payment to a physician for a medically
	necessary telephone consultation with a covered patient if that
	plan pays another person for a telephone consultation with a
	covered patient; or
	(3)  discriminate against a physician in determining a
	payment amount for a medically necessary telephone consultation
	provided to a covered patient if that plan pays another person for a
	telephone consultation with a covered patient.
	(b)  Nothing in this section shall be construed as
	prohibiting an employee benefit plan or a health benefit plan from
	paying a physician for medically necessary telephone
	consultations.
	(c)  Nothing in this section shall be construed as permitting
	a physician to charge or requiring an employee benefit plan or a
	health benefit plan to pay for telephonic:
	(1)  appointment scheduling;
	(2)  appointment reminders; or
	(3)  responses to billing or payment inquiries.
	SECTION 2.  The change in law made by this Act applies only
	to an employee benefit plan or a health benefit plan that is
	delivered, issued for delivery, or renewed on or after September 1,
	2015. An employee benefit plan or a health benefit plan delivered,
	issued for delivery, or renewed before September 1, 2015, is
	governed by the law as it existed immediately before the effective
	date of this Act, and that law is continued in effect for that
	purpose.
	SECTION 3.  If before implementing any provision of this Act
	a state agency determines that a waiver or authorization from a
	federal agency is necessary for implementation of that provision,
	the agency affected by the provision shall request the waiver or
	authorization and may delay implementing that provision until the
	waiver or authorization is granted.
	SECTION 4.  This Act takes effect September 1, 2015.