HBA-ATS H.B. 2049 76(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 2049 By: Thompson Insurance 4/11/1999 Introduced 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 do so 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 or doctor of oriental medicine in the list of practitioners in Article 3.70-2(B) and Section 3, Article 21.52, Insurance Code. 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 (B), Article 3.70-2, Insurance Code, to include Licensed Acupuncturist or Doctor of Oriental Medicine 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. Defines "Licensed Acupuncturist or Doctor of Oriental Medicine" to mean one licensed by the Texas State Board of Medical Examiners. SECTION 2. Amends Section 3, Article 21.52, Insurance Code, to include a licensed acupuncturist or doctor of oriental medicine 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. Makes conforming changes. SECTION 3.Effective date: September 1, 1999. SECTION 4.Emergency clause. Effective date: upon passage.