H.B. No. 711

	AN ACT
	relating to certain contract provisions and conduct affecting
	health care provider networks.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Section 1458.001, Insurance Code, is amended by
	adding Subdivisions (1-a), (1-b), (4-a), (4-b), and (5-a) to read
	as follows:
	(1-a)  "Anti-steering clause" means a provision in a
	provider network contract that restricts the ability of a general
	contracting entity to encourage an enrollee to obtain a health care
	service from a competitor of the provider, including offering
	incentives to encourage enrollees to use specific providers.
	(1-b)  "Anti-tiering clause" means a provision in a
	provider network contract that:
	(A)  restricts the ability of a general
	contracting entity to introduce or modify a tiered network plan or
	assign providers into tiers; or
	(B)  requires a general contracting entity to
	place all members of a provider in the same tier of a tiered network
	plan.
	(4-a)  "Gag clause" means a provision in a provider
	network contract that restricts the ability of a general
	contracting entity or provider to disclose:
	(A)  price or quality information, including the
	allowed amount, negotiated rates or discounts, fees for services,
	or other claim-related financial obligations included in the
	contract, to a governmental entity as authorized by law or its
	contractors or agents, an enrollee, a treating provider of an
	enrollee, a plan sponsor, or potential eligible enrollees and plan
	sponsors; or
	(B)  out-of-pocket costs to an enrollee.
	(4-b)  "General contracting entity" means a person who
	enters into a direct contract with a provider for the delivery of
	health care services to covered individuals regardless of whether
	the person, in the ordinary course of business, establishes a
	provider network for access by another party.  The term does not
	include a health care provider or facility unless the provider or
	facility is entering into the contract in the provider's or
	facility's role as a health benefit plan.
	(5-a)  "Most favored nation clause" means a provision
	in a provider network contract that:
	(A)  prohibits or grants an option to prohibit:
	(i)  a provider from contracting with
	another general contracting entity to provide health care services
	at a lower rate; or
	(ii)  a general contracting entity from
	contracting with another provider to provide health care services
	at a higher rate;
	(B)  requires or grants an option to require:
	(i)  a provider to accept a lower rate for
	health care services if the provider agrees with another general
	contracting entity to accept a lower rate for the services; or
	(ii)  a general contracting entity to pay a
	higher rate for health care services if the entity agrees with
	another provider to pay a higher rate for the services;
	(C)  requires or grants an option to require
	termination or renegotiation of an existing provider network
	contract if:
	(i)  a provider agrees with another general
	contracting entity to accept a lower rate for providing health care
	services; or
	(ii)  a general contracting entity agrees
	with a provider to pay a higher rate for health care services; or
	(D)  requires:
	(i)  a provider to disclose the provider's
	contractual reimbursement rates with other general contracting
	entities; or
	(ii)  a general contracting entity to
	disclose the general contracting entity's contractual
	reimbursement rates with other providers.
	SECTION 2.  Section 1458.101, Insurance Code, is amended by
	adding Subsections (g), (h), and (i) to read as follows:
	(g)  A provider may not:
	(1)  offer to a general contracting entity a written
	provider network contract that includes an anti-steering,
	anti-tiering, gag, or most favored nation clause;
	(2)  enter into a provider network contract that
	includes an anti-steering, anti-tiering, gag, or most favored
	nation clause; or
	(3)  amend or renew an existing provider network
	contract previously entered into with a general contracting entity
	so that the contract as amended or renewed adds or retains an
	anti-steering, anti-tiering, gag, or most favored nation clause.
	(h)  Any provision in a provider network contract that is an
	anti-steering, anti-tiering, gag, or most favored nation clause is
	void and unenforceable. The remaining provisions in the provider
	network contract remain in effect and are enforceable.
	(i)  A health benefit plan issuer that encourages an enrollee
	to obtain a health care service from a particular provider,
	including offering incentives to encourage enrollees to use
	specific providers, or that introduces or modifies a tiered network
	plan or assigns providers into tiers has a fiduciary duty to the
	enrollee or policyholder to engage in that conduct only for the
	primary benefit of the enrollee or policyholder.
	SECTION 3.  Notwithstanding Section 1458.101, Insurance
	Code, as amended by this Act, an anti-steering or anti-tiering
	provision in a provider network contract that exists on the
	effective date of this Act and that would otherwise be prohibited by
	the provisions of this Act remains in effect and enforceable until
	the earlier of:
	(1)  the effective date of an amendment to the provider
	network contract that eliminates the anti-steering or anti-tiering
	provision from the provider network contract and that is entered
	into in accordance with the provider network contract's terms; or
	(2)  December 31, 2023.
	SECTION 4.  This Act takes effect immediately if it receives
	a vote of two-thirds of all the members elected to each house, as
	provided by Section 39, Article III, Texas Constitution. If this
	Act does not receive the vote necessary for immediate effect, this
	Act takes effect September 1, 2023.
	______________________________	______________________________
	President of the Senate	Speaker of the House
	I certify that H.B. No. 711 was passed by the House on April
	25, 2023, by the following vote:  Yeas 146, Nays 0, 1 present, not
	voting; and that the House concurred in Senate amendments to H.B.
	No. 711 on May 25, 2023, by the following vote:  Yeas 137, Nays 0, 1
	present, not voting.
	______________________________
	Chief Clerk of the House
	I certify that H.B. No. 711 was passed by the Senate, with
	amendments, on May 21, 2023, by the following vote:  Yeas 30, Nays
	1.
	______________________________
	Secretary of the Senate
	APPROVED: __________________
	Date
	__________________
	Governor