Bill Text: TX SB1221 | 2013-2014 | 83rd Legislature | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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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-Introduced.html

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83R7232 KKR-F
By: Paxton S.B. No. 1221

A BILL TO BE ENTITLED
AN ACT
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. DEFINITION. In this subchapter, "health
care provider" means an individual or entity who furnishes services
under a license, certificate, registration, or other authority
issued by this state or another state to diagnose, prevent,
alleviate, or cure a human illness or injury. The term includes a
physician.
Sec. 1451.452. 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 after the provider is notified of and consents
in writing to the specific access to be provided or transfer to be
made.
SECTION 2. The change in law made by this Act applies only
to a contract entered into or renewed on or after January 1, 2014. A
contract entered into or renewed before January 1, 2014, is
governed by the law in effect 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, 2013.