85R6881 BEE-D     By: Bonnen of Galveston H.B. No. 3216       A BILL TO BE ENTITLED   AN ACT   relating to maintenance of certification by a physician or an   applicant for a license to practice medicine in this state.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Subtitle F, Title 8, Insurance Code, is amended   by adding Chapter 1461 to read as follows:   CHAPTER 1461. DISCRIMINATION AGAINST PHYSICIAN BASED ON   MAINTENANCE OF CERTIFICATION          Sec. 1461.001.  DEFINITIONS. In this chapter:                (1)  "Enrollee" means an individual who is eligible to   receive health care services under a managed care plan.                (2)  "Maintenance of certification" has the meaning   assigned by Section 151.002, Occupations Code.                (3)  "Managed care plan" means a health benefit plan   under which medical care services are provided to enrollees through   contracts with physicians and that requires enrollees to use   participating physicians or that provides a different level of   coverage for enrollees who use participating physicians.  The term   includes a health benefit plan issued by:                      (A)  a health maintenance organization;                      (B)  a preferred provider benefit plan issuer; or                      (C)  any other entity that issues a health benefit   plan, including an insurance company.                (4)  "Participating physician" means a physician who   has directly or indirectly contracted with a health benefit plan   issuer to provide services to enrollees.                (5)  "Physician" means a person licensed to practice   medicine in this state.          Sec. 1461.002.  APPLICABILITY. (a)  This chapter applies to   a physician regardless of whether the physician is a participating   physician.          (b)  This chapter applies to a person to whom a managed care   plan issuer contracts to:                (1)  process or pay claims;                (2)  obtain the services of physicians to provide   medical care services to enrollees; or                (3)  issue verifications or preauthorizations.          Sec. 1461.003.  DISCRIMINATION BASED ON MAINTENANCE OF   CERTIFICATION. A managed care plan issuer may not differentiate   between physicians based solely on a physician's maintenance of   certification in regard to:                (1)  paying the physician;                (2)  reimbursing the physician; or                 (3)  directly or indirectly contracting with the   physician to provide services to enrollees.          SECTION 2.  Section 151.002(a), Occupations Code, is amended   by adding Subdivision (6-b) to read as follows:                (6-b)  "Maintenance of certification" means the   satisfactory completion of periodic recertification examinations   required to maintain certification after an initial certification   under a medical specialty member board, including the member boards   of the American Board of Medical Specialties or the specialty   certifying boards of the American Osteopathic Association.          SECTION 3.  Subchapter B, Chapter 151, Occupations Code, is   amended by adding Section 151.0515 to read as follows:          Sec. 151.0515.  DISCRIMINATION BASED ON MAINTENANCE OF   CERTIFICATION. A hospital, institution, or program that is   licensed by this state, is operated by this state or a political   subdivision of this state, or directly or indirectly receives state   financial assistance may not differentiate between physicians   based solely on a physician's maintenance of certification.          SECTION 4.  Section 155.003, Occupations Code, is amended by   amending Subsection (d) and adding Subsection (d-1) to read as   follows:          (d)  Except as provided by Subsection (d-1), in [In] addition   to the other requirements prescribed by this subtitle, the board   may require an applicant to comply with other requirements that the   board considers appropriate.          (d-1)  The board may not require maintenance of   certification by an applicant for the applicant to be eligible for a   license under this chapter.          SECTION 5.  Section 156.001, Occupations Code, is amended by   adding Subsection (f) to read as follows:          (f)  The board may not adopt a rule requiring maintenance of   certification by a license holder for the license holder to be   eligible for an initial or renewal registration permit.          SECTION 6.  This Act takes effect September 1, 2017.