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SENATE RESOLUTION
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BE IT RESOLVED by the Senate of the State of Texas, 84th |
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Legislature, Regular Session, 2015, That Senate Rule 12.03 be |
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suspended in part as provided by Senate Rule 12.08 to enable the |
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conference committee appointed to resolve the differences on |
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Senate Bill 684 (the relationship of certain optometrists, |
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therapeutic optometrists, and ophthalmologists with certain |
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managed care plans, including preferred provider plans) to |
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consider and take action on the following matter: |
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Senate Rules 12.03(1) and (3) are suspended to permit the |
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committee to change and add text not in disagreement in proposed |
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SECTION 3 of the bill, in added Section 1451.156, Insurance Code, |
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to read as follows: |
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SECTION 3. Subchapter D, Chapter 1451, Insurance Code, |
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is amended by adding Section 1451.156 to read as follows: |
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Sec. 1451.156. PROHIBITED CONDUCT. (a) A managed care |
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plan, as described by Section 1451.152(a), may not directly or |
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indirectly: |
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(1) control or attempt to control the professional |
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judgment, manner of practice, or practice of an optometrist or |
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therapeutic optometrist; |
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(2) employ an optometrist or therapeutic |
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optometrist to provide a vision care product or service as |
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defined by Section 1451.155; |
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(3) pay an optometrist or therapeutic optometrist |
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for a service not provided; |
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(4) restrict or limit an optometrist's or |
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therapeutic optometrist's choice of sources or suppliers of |
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services or materials, including optical laboratories used by |
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the optometrist or therapeutic optometrist to provide services |
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or materials to a patient; or |
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(5) require an optometrist or therapeutic |
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optometrist to disclose a patient's confidential or protected |
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health information unless the disclosure is authorized by the |
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patient or permitted without authorization under the Health |
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Insurance Portability and Accountability Act of 1996 (42 U.S.C. |
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Section 1320d et seq.) or under Section 602.053. |
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(b) Subsection (a)(2) does not prohibit a managed care |
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plan from employing an optometrist or therapeutic optometrist |
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for utilization review or for operations of the managed care |
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plan. |
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(c) Subsection (a)(3) does not prohibit the use of |
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capitation as a method of payment. |
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(d) Subsection (a)(4) does not restrict or limit a |
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managed care plan's determination of specific amounts of |
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coverage or reimbursement for the use of network or |
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out-of-network suppliers or laboratories. |
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(e) An optometrist or therapeutic optometrist must |
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disclose to a patient any business interest the optometrist or |
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therapeutic optometrist has in an out-of-network supplier or |
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manufacturer to which the optometrist or therapeutic optometrist |
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refers the patient. |
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(f) This section shall be liberally construed to prevent |
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managed care plans from controlling or attempting to control the |
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professional judgment, manner of practice, or practice of an |
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optometrist or therapeutic optometrist. |
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Explanation: The change and addition are necessary to |
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clarify the scope of the authority of a managed care plan to |
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employ an optometrist or therapeutic optometrist and to require |
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an optometrist or therapeutic optometrist to disclose a business |
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interest in an out-of-network entity to which a patient is |
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referred. |
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_______________________________ |
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President of the Senate |
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I hereby certify that the |
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above Resolution was adopted by |
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the Senate on May 29, 2015, by the |
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following vote: Yeas 31, Nays 0. |
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_______________________________ |
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Secretary of the Senate |