Bill Text: TX HB2632 | 2019-2020 | 86th Legislature | Engrossed
Bill Title: Relating to notice by certain managed care entities of changes related to reimbursements applicable to certain physicians and health care providers.
Spectrum: Moderate Partisan Bill (Democrat 15-4)
Status: (Engrossed - Dead) 2019-05-06 - Referred to Business & Commerce [HB2632 Detail]
Download: Texas-2019-HB2632-Engrossed.html
| 86R24398 JES-D | ||
| By: J. Johnson of Dallas, Oliverson, Guillen, | H.B. No. 2632 | |
| et al. | ||
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| relating to notice by certain managed care entities of changes | ||
| related to reimbursements applicable to certain physicians and | ||
| health care providers. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Section 843.321, Insurance Code, is amended by | ||
| adding Subsection (a-1) to read as follows: | ||
| (a-1) A health maintenance organization or health | ||
| maintenance organization's agent that provides a notice under | ||
| Subsection (a)(3) must provide the notice to a physician or | ||
| provider, including a licensed clinical social worker, in a manner | ||
| that is trackable and indicates the date and time the notice was | ||
| sent, including: | ||
| (1) by certified mail, return receipt requested, to | ||
| the physician's or provider's address; or | ||
| (2) by e-mail to an e-mail address specified by the | ||
| physician or provider. | ||
| SECTION 2. Section 1301.136, Insurance Code, is amended by | ||
| adding Subsection (a-1) to read as follows: | ||
| (a-1) An insurer or insurer's agent that provides a notice | ||
| under Subsection (a)(3) must provide the notice to a preferred | ||
| provider, including a licensed clinical social worker, in a manner | ||
| that is trackable and indicates the date and time the notice was | ||
| sent, including: | ||
| (1) by certified mail, return receipt requested, to | ||
| the preferred provider's address; or | ||
| (2) by e-mail to an e-mail address specified by the | ||
| preferred provider. | ||
| SECTION 3. The heading to Chapter 1453, Insurance Code, is | ||
| amended to read as follows: | ||
| CHAPTER 1453. DISCLOSURE OF REIMBURSEMENT GUIDELINES AND AMOUNTS | ||
| UNDER MANAGED CARE PLAN | ||
| SECTION 4. Section 1453.001(1), Insurance Code, is amended | ||
| to read as follows: | ||
| (1) "Health care provider" means: | ||
| (A) a hospital, emergency clinic, outpatient | ||
| clinic, or other facility providing health care services; or | ||
| (B) an individual who is licensed in this state | ||
| to provide health care services, including a physician who is | ||
| licensed to practice medicine in this state. | ||
| SECTION 5. Chapter 1453, Insurance Code, is amended by | ||
| adding Section 1453.004 to read as follows: | ||
| Sec. 1453.004. NOTICE OF CHANGE TO REIMBURSEMENT AMOUNT. | ||
| (a) A managed care entity shall provide to each health care | ||
| provider, including a licensed clinical social worker, under | ||
| contract with the managed care entity notice of any change to a | ||
| reimbursement amount that will be paid to the health care provider | ||
| for a good or service provided by the health care provider. The | ||
| notice must be provided before the effective date of the change. | ||
| (b) The notice required by this section must be sent: | ||
| (1) directly to each health care provider that may be | ||
| affected by the reimbursement amount change; and | ||
| (2) in a manner that is trackable and indicates the | ||
| date and time the notice was sent, including: | ||
| (A) by certified mail, return receipt requested, | ||
| to the provider's address; or | ||
| (B) by e-mail to an e-mail address specified by | ||
| the provider. | ||
| SECTION 6. This Act takes effect September 1, 2019. | ||
