2017S0446-1 03/09/17     By: Hancock S.B. No. 2210     A BILL TO BE ENTITLED   AN ACT   relating to requirements for updating information provided by   certain health benefit plans through the Internet.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Sections 842.261(b) and (c), Insurance Code, are   amended to read as follows:          (b)  The group hospital service corporation shall update at   least once every two business days [quarterly] an Internet site   subject to this section and adhere to the requirements of Sections   1451.504 and 1451.505, including time frames for updating   information, with regard to the Internet site listing required   under this section.          (c)  The commissioner may adopt rules as necessary to   implement this section. The rules may govern the form and content   of the information required to be provided under this section   [Subsection (a)].          SECTION 2.  Sections 843.2015(b) and (c), Insurance Code,   are amended to read as follows:          (b)  The health maintenance organization shall update at   least once every two business days [quarterly] an Internet site   subject to this section and adhere to the requirements of Sections   1451.504 and 1451.505, including time frames for updating   information, with regard to the Internet site listing required   under this section.          (c)  The commissioner may adopt rules as necessary to   implement this section. The rules may govern the form and content   of the information required to be provided under this section   [Subsection (a)].          SECTION 3.  Sections 1301.1591(b) and (c), Insurance Code,   are amended to read as follows:          (b)  The insurer shall update at least once every two   business days [quarterly] an Internet site subject to this section   and adhere to the requirements of Sections 1451.504 and 1451.505,   including time frames for updating information, with regard to the   Internet site listing required under this section.          (c)  The commissioner may adopt rules as necessary to   implement this section. The rules may govern the form and content   of the information required to be provided under this section   [Subsection (a)].          SECTION 4.  Section 1451.504(b), Insurance Code, is amended   to read as follows:          (b)  The directory must include the name, specialty, if any,   street address, and telephone number of each physician and health   care provider described by Subsection (a) and indicate whether the   physician or provider is accepting new patients.          SECTION 5.  Section 1451.505, Insurance Code, is amended by   amending Subsections (c), (d), and (e) and adding Subsections   (d-1), (d-2), and (f) through (j) to read as follows:          (c)  The directory must be:                (1)  electronically searchable by physician or health   care provider name, specialty, if any, and location; and                (2)  publicly accessible without necessity of   providing a password, a user name, or personally identifiable   information.          (d)  The health benefit plan issuer shall conduct an ongoing   review of the directory and correct or update the information as   necessary. Except as provided by Subsections (d-1), (d-2), and   [Subsection] (e), corrections and updates, if any, must be made not   less than once every two business days [each month].          (d-1)  The health benefit plan issuer must update the   directory to:                  (1)  appropriately list a physician or health care   provider not later than four business days after the effective date   of a contract that establishes the physician or health care   provider's network participation in a health benefit plan offered   by the health benefit plan issuer; or                (2)  remove from a corresponding network listing in the   directory, not later than four business days after the effective   date of the termination, a physician or health care provider who   voluntarily requests termination of a contract on which the   physician or health care provider's participation in a network used   by a health benefit plan issued by the health benefit plan issuer is   based.          (d-2)  If a physician or health care provider's contract, on   which network participation is based, is terminated for a reason   other than the physician or health care provider's request, the   health benefit plan issuer:                (1)  if otherwise subject to the notification waiting   period of Section 843.308 or 1301.160 and the termination is not for   a reason related to imminent harm:                      (A)  may not remove the physician or health care   provider's corresponding network listing in the directory until the   date described by Paragraph (B); and                      (B)  must remove the physician or health care   provider's corresponding network listing in the directory not later   than four business days after the later of:                            (i)  the effective date of the termination;   or                            (ii)  the time at which a review panel makes   a formal recommendation regarding the termination;                 (2)  if otherwise subject to the notification waiting   period of Section 843.308 or 1301.160 and the termination is for a   reason related to imminent harm:                      (A)  may remove the physician or health care   provider's corresponding network listing in the directory   immediately; and                      (B)  must remove the physician or health care   provider's corresponding network listing in the directory not later   than four business days after the effective date of the   termination; or                (3)  if not otherwise subject to the notification   waiting period of Section 843.308 or 1301.160, must remove the   physician or health care provider's corresponding network listing   in the directory not later than four business days after the   effective date of the termination.          (e)  The health benefit plan issuer shall conspicuously   display in the directory required by Section 1451.504 an e-mail   address and a toll-free telephone number to which any individual   may report any inaccuracy in the directory. If the issuer receives   a report from any person that specifically identified directory   information may be inaccurate, the issuer shall investigate the   report and correct the information, as necessary, not later than:                (1)  the second business [seventh] day after the date   the report is received if the information identified in the report   concerns the health benefit plan issuer's representation of the   network participation status of the physician or health care   provider; or                (2)  the fifth day after the date the report is received   if the information identified in the report concerns any other type   of information in the directory.          (f)  If, in any 30-day period, the health benefit plan issuer   receives three or more reports alleging that the health benefit   plan issuer's directory erroneously listed a physician or health   care provider as participating in a network used by a health benefit   plan offered by the issuer when the physician or provider was not   participating in that network or alleging that the health benefit   plan issuer's directory erroneously listed a physician or health   care provider as not participating in a network in which the   physician or health care provider was participating and the health   benefit plan issuer's investigation results in a finding that   substantiates those allegations, the health benefit plan issuer   shall immediately report this occurrence to the commissioner.          (g)  On receipt of a report under Subsection (f), the   commissioner shall investigate the health benefit plan issuer's   compliance with Subsections (d-1) and (d-2).          (h)  A health benefit plan issuer investigated under   Subsection (g) shall pay the cost of the investigation in an amount   determined by the commissioner.  The department shall collect an   assessment in an amount determined by the commissioner from the   health benefit plan issuer at the time of the investigation to cover   all expenses attributable directly to the investigation, including   the salaries and expenses of department employees and all   reasonable expenses of the department necessary for the   administration of the investigation.          (i)  The department shall deposit an assessment collected   under this section to the credit of the Texas Department of   Insurance operating account. Money deposited under this subsection   shall be used to pay the salaries and expenses of investigators and   all other expenses relating to the investigation of health benefit   plan issuers under Subsection (g).          (j)  The commissioner's authority under Subsection (g) is in   addition to the authority of the commissioner to take any other   action or order any other appropriate corrective action, sanction,   or penalty under the authority of the commissioner in this code.          SECTION 6.  This Act takes effect September 1, 2017.