Bill Text: TX HB2149 | 2011-2012 | 82nd Legislature | Introduced
Bill Title: Relating to contracts between rural hospitals and certain insurers.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2011-05-06 - Considered in Calendars [HB2149 Detail]
Download: Texas-2011-HB2149-Introduced.html
| 82R10273 PMO-F | ||
| By: Eiland | H.B. No. 2149 | |
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| relating to contracts between rural hospitals and certain insurers. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Subchapter I, Chapter 843, Insurance Code, is | ||
| amended by adding Section 843.324 to read as follows: | ||
| Sec. 843.324. CONTRACTS WITH RURAL HOSPITALS. (a) In this | ||
| section: | ||
| (1) "Ancillary services" means laboratory services, | ||
| radiology services, physical therapy services, speech therapy | ||
| services, or occupational therapy services. | ||
| (2) "Rural hospital" means a hospital that: | ||
| (A) is designated as a critical access hospital | ||
| under and in compliance with 42 U.S.C. Section 1395i-4; | ||
| (B) is a sole community hospital, as defined by | ||
| 42 U.S.C. Section 1395ww(d)(5)(D)(iii); or | ||
| (C) is located in a county with a population of | ||
| not more than 50,000. | ||
| (b) A health maintenance organization that contracts with a | ||
| rural hospital to provide services to enrollees under a health care | ||
| plan may not deny the hospital the opportunity to provide ancillary | ||
| services. | ||
| (c) On request of a rural hospital, the commissioner shall | ||
| conduct an investigation, review, hearing, or other proceeding to | ||
| determine whether a health maintenance organization is in | ||
| compliance with this section. | ||
| (d) The commissioner shall take reasonable action to ensure | ||
| compliance with this section, including issuing orders and imposing | ||
| sanctions. | ||
| SECTION 2. Subchapter E, Chapter 1301, Insurance Code, is | ||
| amended by adding Section 1301.203 to read as follows: | ||
| Sec. 1301.203. CONTRACTS WITH RURAL HOSPITALS. (a) In this | ||
| section: | ||
| (1) "Ancillary services" means laboratory services, | ||
| radiology services, physical therapy services, speech therapy | ||
| services, or occupational therapy services. | ||
| (2) "Rural hospital" means a hospital that: | ||
| (A) is designated as a critical access hospital | ||
| under and in compliance with 42 U.S.C. Section 1395i-4; | ||
| (B) is a sole community hospital, as defined by | ||
| 42 U.S.C. Section 1395ww(d)(5)(D)(iii); or | ||
| (C) is located in a county with a population of | ||
| not more than 50,000. | ||
| (b) An insurer that contracts with a rural hospital to | ||
| provide services to insureds under a preferred provider benefit | ||
| plan may not deny the hospital the opportunity to provide ancillary | ||
| services as a preferred provider. | ||
| (c) On request of a rural hospital, the commissioner shall | ||
| conduct an investigation, review, hearing, or other proceeding to | ||
| determine whether an insurer is in compliance with this section. | ||
| (d) The commissioner shall take reasonable action to ensure | ||
| compliance with this section, including issuing orders and imposing | ||
| sanctions. | ||
| SECTION 3. This Act takes effect September 1, 2011. | ||
