85R12211 SMT-F     By: Schwertner S.B. No. 1413       A BILL TO BE ENTITLED   AN ACT   relating to health maintenance organization contracts with certain   entities to provide health care services.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 843.101, Insurance Code, is amended by   amending Subsection (b) and adding Subsections (b-1) and (b-2) to   read as follows:          (b)  A health maintenance organization may provide or   arrange for health care services only through:                (1)  other health maintenance organizations;                (2)  providers or groups of providers who are:                      (A)  under contract with or are employed by the   health maintenance organization; or                      (B)  under contract with an entity that is under   contract with the health maintenance organization to provide a   network of providers to provide health care services only if the   contract between the entity and the health maintenance   organization:                            (i)  does not limit the health maintenance   organization's authority or responsibility, including financial   responsibility, to comply with any regulatory requirement that   applies to a function performed by the entity;                             (ii)  requires the entity to comply with all   regulatory requirements that apply to a function performed by the   entity; and                            (iii)  expressly sets forth the requirements   of Subparagraphs (i) and (ii); or                (3)  additional health maintenance organizations or   physicians or providers who have contracted for health care   services with:                      (A)  the other health maintenance organizations;                      (B)  physicians with whom the health maintenance   organization has contracted; or                      (C)  providers who are under contract with or are   employed by the health maintenance organization.          (b-1)  Except as provided by Subsection (b-2) and   notwithstanding any other law, an entity described by Subsection   (b)(2)(B) and the health maintenance organization with which the   entity contracts are subject to Chapter 1272 as if the entity were a   delegated entity.          (b-2)  An entity described by Subsection (b)(2)(B) and the   health maintenance organization with which the entity contracts are   not subject to the following provisions:                (1)  Section 1272.053(1);                (2)  Section 1272.057(1);                (3)  Section 1272.061(1)(C); and                 (4)  Subchapter D, Chapter 1272.           SECTION 2.  This Act takes effect September 1, 2017.