Bill Text: TX HB3546 | 2017-2018 | 85th Legislature | Introduced
Bill Title: Relating to out-of-pocket expense credits for payments made by a policyholder directly to a physician or health care provider.
Spectrum: Partisan Bill (Republican 2-0)
Status: (Introduced - Dead) 2017-03-31 - Referred to Insurance [HB3546 Detail]
Download: Texas-2017-HB3546-Introduced.html
85R13864 PMO-D | ||
By: Oliverson | H.B. No. 3546 |
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relating to out-of-pocket expense credits for payments made by a | ||
policyholder 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 covered medical or | ||
health care service if a claim for the service 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 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 health benefit plan that is delivered, | ||
issued for delivery, or renewed on or after January 1, 2018. A | ||
health benefit plan delivered, issued for delivery, or renewed | ||
before January 1, 2018, is governed by the law as it existed | ||
immediately before the effective date of this Act, and that law is | ||
continued in effect for that purpose. | ||
SECTION 3. This Act takes effect September 1, 2017. |