By: Hancock  S.B. No. 2210          (In the Senate - Filed March 10, 2017; March 29, 2017, read   first time and referred to Committee on Business & Commerce;   May 11, 2017, reported adversely, with favorable Committee   Substitute by the following vote:  Yeas 9, Nays 0; May 11, 2017,   sent to printer.)Click here to see the committee vote    COMMITTEE SUBSTITUTE FOR S.B. No. 2210 By:  Hancock     A BILL TO BE ENTITLED   AN ACT     relating to health benefit plan provider network listings and   directories; authorizing an assessment.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 842.261, Insurance Code, is amended by   adding Subsections (a-1) and (a-2) and amending Subsection (c) to   read as follows:          (a-1)  The listing required by Subsection (a) must meet the   requirements of a provider directory under Sections 1451.504 and   1451.505.  The group hospital service corporation is subject to the   requirements of Sections 1451.504 and 1451.505, including the time   limits for directory corrections and updates, with respect to the   listing.          (a-2)  Notwithstanding Subsection (b), a group hospital   service corporation shall update the listing required by Subsection   (a) at least once every five business days.          (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.  Section 843.2015, Insurance Code, is amended by   adding Subsections (a-1) and (a-2) and amending Subsection (c) to   read as follows:          (a-1)  The listing required by Subsection (a) must meet the   requirements of a provider directory under Sections 1451.504 and   1451.505.  The health maintenance organization is subject to the   requirements of Sections 1451.504 and 1451.505, including the time   limits for directory corrections and updates, with respect to the   listing.          (a-2)  Notwithstanding Subsection (b), the health   maintenance organization shall update the listing required by   Subsection (a) at least once every five business days.           (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.  Section 1301.1591, Insurance Code, is amended by   adding Subsections (a-1) and (a-2) and amending Subsection (c) to   read as follows:          (a-1)  The listing required by Subsection (a) must meet the   requirements of a provider directory under Sections 1451.504 and   1451.505.  The insurer is subject to the requirements of Sections   1451.504 and 1451.505, including the time limits for directory   corrections and updates, with respect to the listing.          (a-2)  Notwithstanding Subsection (b), an insurer shall   update the listing required by Subsection (a) at least once every   five business days.          (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.  The heading to Section 1451.505, Insurance Code,   is amended to read as follows:          Sec. 1451.505.  ACCESSIBILITY AND ACCURACY OF PHYSICIAN AND   HEALTH CARE PROVIDER DIRECTORY [ON INTERNET WEBSITE].          SECTION 6.  Section 1451.505, Insurance Code, is amended by   amending Subsections (c), (d), and (e) and adding Subsections   (d-1), (d-2), (d-3), 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), (d-3),   and [Subsection] (e), corrections and updates, if any, must be made   not less than once every five business days [each month].          (d-1)  Except as provided by Subsection (d-2), the health   benefit plan issuer shall update the directory to:                (1)  list a physician or health care provider not later   than four business days after the effective date of the physician's   or health care provider's contract with the health benefit plan   issuer; or                (2)  remove a physician or health care provider not   later than four business days after the effective date of the   termination of the physician's or health care provider's contract   with the health benefit plan issuer.          (d-2)  Except as provided by Subsection (d-3), if the   termination of the physician's or health care provider's contract   with the health benefit plan issuer was not at the request of the   physician or health care provider and the health benefit plan   issuer is subject to Section 843.308 or 1301.160, the health   benefit plan issuer shall remove the physician or health care   provider from the directory not later than four business days after   the later of:                (1)  the date of a formal recommendation under Section   843.306 or 1301.057, as applicable; or                (2)  the effective date of the termination.          (d-3)  If the termination was related to imminent harm, the   health benefit plan issuer shall remove the physician or health   care provider from the directory in the time provided by Subsection   (d-1)(2).          (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 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 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 that allege the health benefit plan   issuer's directory inaccurately represents a physician's or a   health care provider's network participation status and that are   confirmed by the health benefit plan issuer's investigation, the   health benefit plan issuer shall immediately report that 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), (d-2), and (d-3).          (h)  A health benefit plan issuer investigated under this   section shall pay the cost of the investigation in an amount   determined by the commissioner.          (i)  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 this section.  The   department shall deposit an assessment collected under this section   to the credit of the Texas Department of Insurance operating   account.          (j)  Money deposited under this section shall be used to pay   the salaries and expenses of investigators and all other expenses   related to the investigation of a health benefit plan issuer under   this section.          SECTION 7.  This Act takes effect September 1, 2017.     * * * * *