Bill Text: TX HB1675 | 2017-2018 | 85th Legislature | Introduced
Bill Title: Relating to the methods of payment to health care providers by certain health benefit plan issuers.
Sponsorship: Partisan Bill (Republican 1)
Status: (Introduced - Dead) 2017-04-04 - Left pending in committee [HB1675 Detail]
Download: Texas-2017-HB1675-Introduced.html
| 85R6793 PMO-F | ||
| By: Flynn | H.B. No. 1675 | |
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| relating to the methods of payment to health care providers by | ||
| certain health benefit plan issuers. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Subtitle F, Title 8, Insurance Code, is amended | ||
| by adding Chapter 1468 to read as follows: | ||
| CHAPTER 1468. METHODS OF PAYMENT OF PHYSICIANS AND HEALTH CARE | ||
| PROVIDERS | ||
| Sec. 1468.001. DEFINITIONS. In this chapter: | ||
| (1) "Health benefit plan issuer" means an entity | ||
| authorized under this code or another insurance law of this state | ||
| that provides health insurance or health benefits in this state, | ||
| including: | ||
| (A) an insurance company; | ||
| (B) a group hospital service corporation | ||
| operating under Chapter 842; | ||
| (C) a health maintenance organization operating | ||
| under Chapter 843; and | ||
| (D) a stipulated premium company operating under | ||
| Chapter 884. | ||
| (2) "Health care provider" means a practitioner, | ||
| institutional provider, or other person or organization that | ||
| furnishes health care services and that is licensed or otherwise | ||
| authorized to practice in this state. The term includes a | ||
| pharmacist, pharmacy, hospital, nursing home, or other medical or | ||
| health-related service facility that provides care for the sick or | ||
| injured or other care. The term does not include a physician. | ||
| (3) "Physician" means an individual licensed to | ||
| practice medicine in this state. | ||
| Sec. 1468.002. METHODS OF PAYMENT. (a) Subject to | ||
| Subsection (b), a health benefit plan issuer or a person with whom a | ||
| health benefit plan issuer contracts to process or pay physician or | ||
| health care provider claims may pay a physician or health care | ||
| provider by any lawful method of payment, including: | ||
| (1) an automated clearinghouse payment; | ||
| (2) a wire transfer; | ||
| (3) electronic funds transfer by card; | ||
| (4) payment through a private card network; or | ||
| (5) another form of electronic funds transfer. | ||
| (b) Unless a contract between the health benefit plan issuer | ||
| and the physician or health care provider specifies the method of | ||
| payment, a physician or health care provider may refuse to accept a | ||
| method of payment allowed under Subsection (a). | ||
| (c) A physician or health care provider that refuses to | ||
| accept a method of payment allowed under Subsection (a) shall give | ||
| written notice of the refusal to the health benefit plan issuer or | ||
| the person with whom the health benefit plan issuer contracts to | ||
| process or pay physician or health care provider claims and specify | ||
| an acceptable and otherwise lawful method of payment. | ||
| SECTION 2. This Act takes effect September 1, 2017. | ||
