TITLE 1.ADMINISTRATION

Part 3. OFFICE OF THE ATTORNEY GENERAL

Chapter 58. PHYSICIAN JOINT NEGOTIATION

Subchapter A. GENERAL

1 TAC §58.6

The Office of the Attorney General (OAG) adopts new §58.6, relating to podiatric physicians' participation in joint negotiations by physicians with health benefit plans. Section 58.6 is adopted without changes to the proposed text as published in the June 2, 2000, Texas Register (25 TexReg 4977).

The new section is adopted to implement SB 1468, 76th Leg., R.S., ch.1586 (1999) (codified at Insurance Code, Chapter 29), which allows competing physicians to jointly negotiate with health benefit plans when certain conditions are met. Insurance Code, Art. 29.11 authorizes the OAG and the Texas Department of Insurance (TDI) to authorize podiatric physicians to participate in the joint negotiations permitted by Chapter 29.

The new section was proposed as a result of comments received in response to a separate rulemaking regarding Chapter 58, which was published as proposed rules in the November 19, 1999, issue of the Texas Register (24 TexReg 10263), and adopted in the June 2, 2000, Texas Register (25 TexReg 5301). As part of that rulemaking, the Texas Podiatric Medical Association and dozens of individual podiatrists submitted comments urging the OAG to clarify that podiatrists and physicians may participate together as members of a negotiation group, and provide that podiatrists, acting independently of physicians, may initiate and participate in the joint negotiations permitted by Chapter 29.

Because Insurance Code Art. 29.11 specifically contemplates participation by podiatric physicians in joint negotiations, the OAG believes that expanding access to joint negotiations to include podiatrists is consistent with the legislature's intent and the purpose of Chapter 29. Like ordinary physicians, podiatrists contract with health benefit plans for the provision of professional medical services. In addition, podiatrists sometimes practice together in a multispecialty group with other physicians. Accordingly, the OAG believes it is appropriate to authorize podiatric physicians to participate in joint negotiations either independently or together with other physicians.

The new §58.6 defines "physician" to include "a person licensed to practice podiatry by the Texas State Board of Podiatric Medical Examiners" for the purpose of participating in the joint negotiations permitted by Chapter 29. It is intended to permit podiatrists to participate in joint negotiations to the same extent as, and subject to the same requirements as physicians under Chapter 58 and Insurance Code, Chapter 29.

The OAG has not received any comments regarding proposed §58.6.

The new section is adopted under the Insurance Code, Article 29.11, which the OAG interprets as authorizing the Office of the Attorney General to adopt rules to authorize podiatric physicians to participate in the joint negotiations permitted by Chapter 29.

The new section affects Texas Insurance Code, Chapter 29.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on July 14, 2000.

TRD-200004894

Rick Gilpin

Assistant Attorney General

Office of the Attorney General

Effective date: August 3, 2000

Proposal publication date: June 2, 2000

For further information, please call A. G. Younger at (512) 463-2110.