Bill Text: TX SB1221 | 2013-2014 | 83rd Legislature | Enrolled
Bill Title: Relating to use of a Medicaid-based fee schedule for reimbursement of services under a contract between a health care provider and certain health benefit plans.
Sponsorship: Partisan Bill (Republican 2)
Status: (Passed) 2013-06-14 - Effective immediately [SB1221 Detail]
Download: Texas-2013-SB1221-Enrolled.html
| S.B. No. 1221 | ||
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| relating to use of a Medicaid-based fee schedule for reimbursement | ||
| of services under a contract between a health care provider and | ||
| certain health benefit plans. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Chapter 1451, Insurance Code, is amended by | ||
| adding Subchapter J to read as follows: | ||
| SUBCHAPTER J. REIMBURSEMENT OF HEALTH CARE PROVIDERS | ||
| Sec. 1451.451. REIMBURSEMENT UNDER MEDICAID-BASED FEE | ||
| SCHEDULE. (a) An insurance company, health maintenance | ||
| organization, or preferred provider organization that contracts | ||
| with a health care provider to provide services in connection with | ||
| Chapter 533, Government Code, or Chapter 62, Health and Safety | ||
| Code, may not require the health care provider to provide access to | ||
| or transfer the provider's name and contracted discounted fee for | ||
| use with health benefit plans issued to individuals and groups | ||
| under Chapter 1271 or 1301. | ||
| (b) An insurance company, health maintenance organization, | ||
| or preferred provider organization may provide access to or | ||
| transfer a provider's name and discounted fee described by | ||
| Subsection (a) only if: | ||
| (1) the insurance company, health maintenance | ||
| organization, or preferred provider organization provides written | ||
| notice to the provider that is printed in conspicuous boldface type | ||
| near a separate signature line and includes a statement | ||
| substantially similar to the following: "By signing on this line, | ||
| you may be agreeing to apply this company's Medicaid or CHIP fee | ||
| schedule to services you provide to commercial insurance or HMO | ||
| enrollees."; and | ||
| (2) the provider authorizes the access or transfer and | ||
| agrees to accept the contracted discounted fee by signing the | ||
| notice described in Subdivision (1). | ||
| SECTION 2. The change in law made by this Act applies only | ||
| to a contract entered into or renewed on or after the effective date | ||
| of this Act. A contract entered into or renewed before the | ||
| effective date of this Act is governed by the law in effect at the | ||
| time the contract is entered into or renewed, and that law is | ||
| continued in effect for that purpose. | ||
| SECTION 3. 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, 2013. | ||
| ______________________________ | ______________________________ | |
| President of the Senate | Speaker of the House | |
| I hereby certify that S.B. No. 1221 passed the Senate on | ||
| April 25, 2013, by the following vote: Yeas 30, Nays 0. | ||
| ______________________________ | ||
| Secretary of the Senate | ||
| I hereby certify that S.B. No. 1221 passed the House on | ||
| May 21, 2013, by the following vote: Yeas 145, Nays 0, two | ||
| present not voting. | ||
| ______________________________ | ||
| Chief Clerk of the House | ||
| Approved: | ||
| ______________________________ | ||
| Date | ||
| ______________________________ | ||
| Governor | ||
