Bill Text: TX HB3985 | 2023-2024 | 88th Legislature | Introduced
Bill Title: Relating to an insurer's obligation under a preferred provider benefit plan for continuity of care for certain Medicaid recipients.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2023-04-11 - Left pending in committee [HB3985 Detail]
Download: Texas-2023-HB3985-Introduced.html
88R11668 CJD-F | ||
By: Raney | H.B. No. 3985 |
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relating to an insurer's obligation under a preferred provider | ||
benefit plan for continuity of care for certain Medicaid | ||
recipients. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 1301.154, Insurance Code, is amended by | ||
amending Subsection (a) and adding Subsection (c) to read as | ||
follows: | ||
(a) Except as provided by Subsections [ |
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(c), Sections 1301.152 and 1301.153 do not extend an insurer's | ||
obligation to reimburse the terminated physician or provider or, if | ||
applicable, the insured at the preferred provider level of coverage | ||
for ongoing treatment of an insured after: | ||
(1) the 90th day after the [ |
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of the contract [ |
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(2) if the insured has been diagnosed as having a | ||
terminal illness at the time of the termination, the expiration of | ||
the nine-month period after the effective date of the termination. | ||
(c) If an insured is a Medicaid recipient with complex | ||
medical needs who receives Medicaid services through a Medicaid | ||
managed care organization under Chapter 533, Government Code, and | ||
who has established at any time a relationship with a specialty | ||
provider, including a provider of durable medical equipment, | ||
services, or supplies, an insurer's obligation to reimburse, at the | ||
preferred provider level of coverage, the physician or provider or, | ||
if applicable, the insured, extends until a contract has been | ||
implemented under Section 533.038(g), Government Code. | ||
SECTION 2. If before implementing any provision of this Act | ||
a state agency determines that a waiver or authorization from a | ||
federal agency is necessary for implementation of that provision, | ||
the agency affected by the provision shall request the waiver or | ||
authorization and may delay implementing that provision until the | ||
waiver or authorization is granted. | ||
SECTION 3. The change in law made by this Act applies only | ||
to a health benefit plan that is delivered, issued for delivery, or | ||
renewed on or after January 1, 2024. A health benefit plan that is | ||
delivered, issued for delivery, or renewed before January 1, 2024, | ||
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 4. This Act takes effect September 1, 2023. |