By Averitt                                            H.B. No. 1610
         77R6599 T                           
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to data on mandated health benefits and mandated offers of
 1-3     coverage that must be collected and reported by health benefit plan
 1-4     issuers.
 1-5           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-6           SECTION 1.  Chapter 38, Insurance Code is amended by adding
 1-7     new Subchapter F, Data Collecting and Reporting Relating to
 1-8     Mandated Health Benefits and Mandated Offers of Coverage, to read
 1-9     as follows:
1-10           Sec. 38.208.  This subchapter applies to any issuer of a
1-11     health benefit plan that is subject to this code that provides
1-12     benefits for medical or surgical expenses incurred as a result of a
1-13     health condition, accident, or sickness, including an individual,
1-14     group, blanket, or franchise insurance policy or insurance
1-15     agreement, a group hospital service contract, or an individual or
1-16     group evidence of coverage or similar coverage document.
1-17           Sec. 38.209.  The commissioner shall require a health benefit
1-18     plan issuer to collect and report cost and utilization data for
1-19     each mandated health benefit and mandated offer designated by the
1-20     commissioner.
1-21           Sec. 38.210.  The commissioner shall designate by rule:
1-22                 (1)  the issuers of health benefit plans that must
1-23     collect and report data based on the annual dollar amounts of Texas
1-24     premium collected by the health benefit plan issuer;
 2-1                 (2)  the specific mandated health benefits and mandated
 2-2     offers of coverage for which data must be collected;
 2-3                 (3)  a description of the data that must be collected;
 2-4                 (4)  the beginning and ending dates of the reporting
 2-5     periods, which shall be no less than every two years;
 2-6                 (5)  the date following the end of the reporting period
 2-7     by which the report shall be submitted to the commissioner;
 2-8                 (6)  the detail and form in which the report shall be
 2-9     submitted; and
2-10                 (7)  any other reasonable requirements that the
2-11     commissioner determines are necessary to determine the impact of
2-12     mandated benefits and mandated offers of coverage for which data
2-13     collection and reporting is required.
2-14           Sec. 308.211.  The commissioner shall not require reporting
2-15     of data:
2-16                 (1)  that could reasonably be used to identify a
2-17     specific enrollee in a health benefit plan; or
2-18                 (2)  in any way that violates confidentiality
2-19     requirements of state or federal law applicable to an enrollee in a
2-20     health benefit plan.
2-21           Sec 308.212.  Each health benefit plan issuer shall maintain
2-22     at its principle place of business all data collected pursuant to
2-23     this subchapter, including information and supporting documentation
2-24     that demonstrates that the report submitted to the commissioner are
2-25     complete and accurate.  Each health benefit plan issuer shall make
2-26     this information and any supporting documentation available to the
2-27     commissioner upon request.
 3-1           SECTION 2.  This Act takes effect September 1, 2001.