Bill Text: TX HB2002 | 2023-2024 | 88th Legislature | Comm Sub

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Relating to preferred provider benefit plan out-of-pocket expense credits for payments made by an insured directly to a physician or health care provider.

Spectrum: Partisan Bill (Republican 3-0)

Status: (Passed) 2023-06-09 - Effective on 9/1/23 [HB2002 Detail]

Download: Texas-2023-HB2002-Comm_Sub.html

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By: Oliverson, Price (Senate Sponsor - Hancock) H.B. No. 2002
(In the Senate - Received from the House May 5, 2023;
May 8, 2023, read first time and referred to Committee on Health &
Human Services; May 18, 2023, reported favorably by the following
vote: Yeas 8, Nays 0; May 18, 2023, sent to printer.)
Click here to see the committee vote

A BILL TO BE ENTITLED
AN ACT
relating to preferred provider benefit plan out-of-pocket expense
credits for payments made by an insured directly to a physician or
health care provider.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter C-1, Chapter 1301, Insurance Code, is
amended by adding Section 1301.140 to read as follows:
Sec. 1301.140. OUT-OF-POCKET EXPENSE CREDIT. (a) An
insurer shall credit toward an insured's deductible and annual
maximum out-of-pocket expenses an amount the insured pays directly
to any physician or health care provider for a medically necessary
covered medical or health care service or supply if a claim for the
service or supply is not submitted to the insurer and the amount
paid by the insured to the physician or health care provider is less
than the average discounted rate for the service or supply paid to
an equivalently licensed or authorized preferred provider under the
insured's preferred provider benefit plan.
(b) An insurer shall:
(1) establish a procedure by which an insured may
claim a credit under Subsection (a); and
(2) identify documentation necessary to support a
claim for a credit under Subsection (a).
(c) Information about the procedure and documentation
described by Subsection (b) must be readily accessible to an
insured on the insurer's Internet website.
SECTION 2. Section 1301.140, Insurance Code, as added by
this Act, applies only to a preferred provider benefit plan that is
delivered, issued for delivery, or renewed on or after January 1,
2024.
SECTION 3. This Act takes effect September 1, 2023.
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