Bill Text: TX SB1264 | 2019-2020 | 86th Legislature | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Relating to consumer protections against certain medical and health care billing by certain out-of-network providers.
Spectrum: Slight Partisan Bill (Republican 57-26)
Status: (Passed) 2019-06-14 - Effective on 9/1/19 [SB1264 Detail]
Download: Texas-2019-SB1264-Introduced.html
Bill Title: Relating to consumer protections against certain medical and health care billing by certain out-of-network providers.
Spectrum: Slight Partisan Bill (Republican 57-26)
Status: (Passed) 2019-06-14 - Effective on 9/1/19 [SB1264 Detail]
Download: Texas-2019-SB1264-Introduced.html
86R15923 TYPED | ||
By: Hancock | S.B. No. 1264 |
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relating to consumer protections against billing and limitations on | ||
information reported by consumer reporting agencies. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
ARTICLE 1. LIMITATIONS ON SURPRISE BILLING INFORMATION REPORTED BY | ||
CONSUMER REPORTING AGENCIES | ||
SECTION 1.01 Section 20.05, Business & Commerce Code, is | ||
amended by amending Subsection (a) and adding Subsection (d) to | ||
read as follows: | ||
(a) Except as provided by Subsection (b), a consumer | ||
reporting agency may not furnish a consumer report containing | ||
information related to: | ||
(1) a case under Title 11 of the United States Code or | ||
under the federal Bankruptcy Act in which the date of entry of the | ||
order for relief or the date of adjudication predates the consumer | ||
report by more than 10 years; | ||
(2) a suit or judgment in which the date of entry | ||
predates the consumer report by more than seven years or the | ||
governing statute of limitations, whichever is longer; | ||
(3) a tax lien in which the date of payment predates | ||
the consumer report by more than seven years; | ||
(4) a record of arrest, indictment, or conviction of a | ||
crime in which the date of disposition, release, or parole predates | ||
the consumer report by more than seven years; [ |
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(5) a collection account with a medical industry code, | ||
if the consumer was covered by a health benefit plan at the time of | ||
the event giving rise to the collection and the collection is for an | ||
outstanding balance, after copayments, deductibles, and | ||
coinsurance, owed to an emergency care provider or a facility-based | ||
provider for an out-of-network benefit claim; or | ||
(6) another item or event that predates the consumer | ||
report by more than seven years. | ||
(d) In this section: | ||
(1) "Emergency care provider" means a physician, | ||
health care practitioner, facility, or other health care provider | ||
who provides emergency care. | ||
(2) "Facility" has the meaning assigned by Section | ||
324.001, Health and Safety Code. | ||
(3) "Facility-based provider" means a physician, | ||
health care practitioner, or other health care provider who | ||
provides health care or medical services to patients of a facility. | ||
(4) "Health care practitioner" means an individual who | ||
is licensed to provide health care services. | ||
ARTICLE 2. ELIMINATION OF SURPRISE BILLING FOR CERTAIN HEALTH | ||
BENEFIT PLANS | ||
SECTION 2.01. Section 1271.155, Insurance Code, is amended | ||
by amending Subsection (a) and adding Subsection (f) to read as | ||
follows: | ||
(a) A health maintenance organization shall pay for | ||
emergency care performed by non-network physicians or providers in | ||
an amount that the organization determines is reasonable for the | ||
emergency care [ |
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rate. | ||
(f) A non-network physician or provider may not bill a | ||
patient described by this section in, and the patient has no | ||
financial responsibility for, an amount greater than the patient's | ||
responsibility under the patient's health care plan, including an | ||
applicable copayment, coinsurance, or deductible. | ||
SECTION 2.02. Subchapter D, Chapter 1271, Insurance Code, | ||
is amended by adding Section 1271.157 to read as follows: | ||
Sec. 1271.157. NON-NETWORK FACILITY-BASED PROVIDERS. (a) | ||
In this section, "facility-based provider" means a physician or | ||
health care provider who provides health care services to patients | ||
of a health care facility. | ||
(b) A health maintenance organization shall pay for a health | ||
care service performed by a non-network provider who is a | ||
facility-based provider in an amount that the organization | ||
determines is reasonable for the service or at an agreed rate if the | ||
provider performed the service at a health care facility that is a | ||
network provider. | ||
(c) A non-network facility-based provider may not bill a | ||
patient receiving a health care service described by Subsection (b) | ||
in, and the patient does not have financial responsibility for, an | ||
amount greater than the patient's responsibility under the | ||
patient's health care plan, including an applicable copayment, | ||
coinsurance, or deductible. | ||
SECTION 2.03. Subtitle C, Title 8, Insurance Code, is | ||
amended by adding Chapter 1276 to read as follows: | ||
CHAPTER 1276. ELECTIVE PROVISIONS FOR SELF-FUNDED OR SELF-INSURED | ||
MANAGED CARE PLANS | ||
Sec. 1276.0001. DEFINITIONS. In this chapter: | ||
(1) "Eligible plan" means a managed care plan that is a | ||
self-funded or self-insured employee welfare benefit plan that | ||
provides health benefits and is established in accordance with the | ||
Employee Retirement Income Security Act of 1974 (29 U.S.C. Section | ||
1001 et seq.). | ||
(2) "Emergency care" has the meaning assigned by | ||
Section 1301.155. | ||
(3) "Facility-based provider" means a physician or | ||
health care provider who provides health care services to patients | ||
of a health care facility. | ||
(4) "Managed care plan" means a health benefit plan | ||
under which the plan administrator provides or arranges for health | ||
care benefits to plan participants and requires or encourages plan | ||
participants to use physicians and health care providers the plan | ||
designates. | ||
(5) "Out-of-network provider" means, with respect to | ||
an eligible plan, a physician or health care provider who is not a | ||
participating provider. | ||
(6) "Participating provider" means a physician or | ||
health care provider who has contracted with an eligible plan | ||
administrator to provide services to enrollees. | ||
Sec. 1276.0002. ELECTION FOR SURPRISE HEALTH CARE BILLING | ||
PROHIBITION AND MEDIATION. (a) A plan sponsor of an eligible plan | ||
may elect on an annual basis for this section and Chapter 1467 to | ||
apply to the plan. A sponsor making an election shall provide | ||
written notice of the election to the department in the form and | ||
manner required by department rule. | ||
(b) An administrator of an eligible plan for which an | ||
election is made under Subsection (a) shall pay for a health care | ||
service performed by an out-of-network provider in an amount that | ||
the administrator determines is reasonable for the service or at an | ||
agreed rate if: | ||
(1) the provider is a facility-based provider who | ||
performed the service at a health care facility that is a | ||
participating provider; or | ||
(2) the service is emergency care. | ||
(c) An out-of-network provider described by Subsection (b) | ||
may not bill the patient in, and the patient does not have financial | ||
responsibility for, an amount greater than the patient's | ||
responsibility under the patient's eligible plan, including an | ||
applicable copayment, coinsurance, or deductible. | ||
(d) An administrator of an eligible plan for which an | ||
election is made under Subsection (a) shall ensure that the plan and | ||
any evidence of coverage complies with this section and Chapter | ||
1467. | ||
SECTION 2.04. Section 1301.0053, Insurance Code, is amended | ||
to read as follows: | ||
Sec. 1301.0053. EXCLUSIVE PROVIDER BENEFIT PLANS: | ||
EMERGENCY CARE. (a) If a nonpreferred provider provides emergency | ||
care as defined by Section 1301.155 to an enrollee in an exclusive | ||
provider benefit plan, the issuer of the plan shall reimburse the | ||
nonpreferred provider in an amount that the issuer determines is | ||
reasonable for the emergency care services [ |
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nonpreferred provider for the provision of the services. | ||
(b) An out-of-network provider may not bill an insured | ||
receiving emergency care in, and the insured does not have | ||
financial responsibility for, an amount greater than the insured's | ||
responsibility under the insured's exclusive provider benefit | ||
plan, including an applicable copayment, coinsurance, or | ||
deductible. | ||
SECTION 2.05. Section 1301.155, Insurance Code, is amended | ||
by amending Subsection (b) and adding Subsection (c) to read as | ||
follows: | ||
(b) If an insured cannot reasonably reach a preferred | ||
provider, an insurer shall provide reimbursement for the following | ||
emergency care services in an amount that the insurer determines is | ||
reasonable for the services at the preferred level of benefits | ||
until the insured can reasonably be expected to transfer to a | ||
preferred provider: | ||
(1) a medical screening examination or other | ||
evaluation required by state or federal law to be provided in the | ||
emergency facility of a hospital that is necessary to determine | ||
whether a medical emergency condition exists; | ||
(2) necessary emergency care services, including the | ||
treatment and stabilization of an emergency medical condition; and | ||
(3) services originating in a hospital emergency | ||
facility or freestanding emergency medical care facility following | ||
treatment or stabilization of an emergency medical condition. | ||
(c) For purposes of Subsection (b), an out-of-network | ||
provider may not bill an insured in, and the insured does not have | ||
financial responsibility for, an amount greater than the insured's | ||
responsibility under the insured's preferred provider benefit | ||
plan, including an applicable copayment, coinsurance, or | ||
deductible. | ||
SECTION 2.06. Subchapter D, Chapter 1301, Insurance Code, | ||
is amended by adding Section 1301.164 to read as follows: | ||
Sec. 1301.164. OUT-OF-NETWORK FACILITY-BASED PROVIDER. | ||
(a) In this section, "facility-based provider" means a physician, | ||
or health care provider who provides health care services to | ||
patients of a health care facility. | ||
(b) An insurer shall pay for a health care service performed | ||
by a nonpreferred provider who is a facility-based provider in an | ||
amount that the insurer determines is reasonable for the service or | ||
at an agreed rate if the provider performed the service at a health | ||
care facility that is a participating provider. | ||
(c) A nonpreferred provider who is a facility-based | ||
provider may not bill an insured receiving a health care service | ||
described by Subsection (b) in, and the insured does not have | ||
financial responsibility for, an amount greater than the insured's | ||
responsibility under the insured's health care plan, including an | ||
applicable copayment, coinsurance, or deductible. | ||
SECTION 2.07. Subchapter E, Chapter 1551, Insurance Code, | ||
is amended by adding Sections 1551.228 and 1551.229 to read as | ||
follows: | ||
Sec. 1551.228. EMERGENCY CARE COVERAGE. (a) In this | ||
section, "emergency care" has the meaning assigned by Section | ||
1301.155. | ||
(b) A managed care plan provided under the group benefits | ||
program must provide out-of-network emergency care coverage for | ||
participants in accordance with this section. | ||
(c) The coverage must require the administrator of the plan | ||
to pay for emergency care performed by an out-of-network provider | ||
in an amount that the administrator determines is reasonable for | ||
the emergency care or at an agreed rate. | ||
(d) For the purposes of Subsection (c), an out-of-network | ||
provider may not bill an enrollee in, and the enrollee does not have | ||
financial responsibility for, an amount greater than the enrollee's | ||
responsibility under the enrollee's managed care plan, including an | ||
applicable copayment, coinsurance, or deductible. | ||
Sec. 1551.229. OUT-OF-NETWORK FACILITY-BASED PROVIDER | ||
COVERAGE. (a) In this section, "facility-based provider" means a | ||
physician or health care provider who provides health care services | ||
to patients of a health care facility. | ||
(b) A managed care plan provided under the group benefits | ||
program out-of-network facility-based provider must provide | ||
coverage for participants in accordance with this section. | ||
(c) The coverage must require the administrator of the plan | ||
to pay for a health care service performed for an enrollee by an | ||
out-of-network provider who is a facility-based provider in an | ||
amount that the administrator determines is reasonable for the | ||
service or at an agreed rate if the provider performed the service | ||
at a health care facility that is a participating provider. | ||
(d) An out-of-network provider who is a facility-based | ||
provider may not bill an enrollee receiving a health care service | ||
described by Subsection (c) in, and the enrollee does not have | ||
financial responsibility for, an amount greater than the enrollee's | ||
responsibility under the enrollee's managed care plan, including an | ||
applicable copayment, coinsurance, or deductible. | ||
SECTION 2.08. Subchapter D, Chapter 1575, Insurance Code, | ||
is amended by adding Sections 1575.171 and 1575.172 to read as | ||
follows: | ||
Sec. 1575.171. EMERGENCY CARE COVERAGE. (a) In this | ||
section, "emergency care" has the meaning assigned by Section | ||
1301.155. | ||
(b) A managed care plan offered under the group program must | ||
provide out-of-network emergency care coverage in accordance with | ||
this section. | ||
(c) The coverage must require the administrator of the plan | ||
to pay for emergency care performed by an out-of-network provider | ||
in an amount that the administrator determines is reasonable for | ||
the emergency care or at an agreed rate. | ||
(d) For the purposes of Subsection (c), an out-of-network | ||
provider may not bill an enrollee in, and the enrollee does not have | ||
financial responsibility for, an amount greater than the enrollee's | ||
responsibility under the enrollee's managed care plan, including an | ||
applicable copayment, coinsurance, or deductible. | ||
Sec. 1575.172. OUT-OF-NETWORK FACILITY-BASED PROVIDER | ||
COVERAGE. (a) In this section, "facility-based provider" means a | ||
physician or health care provider who provides health care services | ||
to patients of a health care facility. | ||
(b) A managed care plan offered under the group program must | ||
provide out-of-network facility-based provider coverage in | ||
accordance with this section. | ||
(c) The coverage must require the administrator of the plan | ||
to pay for a health care service performed for an enrollee by an | ||
out-of-network provider who is a facility-based provider in an | ||
amount that the administrator determines is reasonable for the | ||
service or at an agreed rate if the provider performed the service | ||
at a health care facility that is a participating provider. | ||
(d) An out-of-network provider who is a facility-based | ||
provider may not bill an enrollee receiving a health care service | ||
described by Subsection (c) in, and the enrollee does not have | ||
financial responsibility for, an amount greater than the enrollee's | ||
responsibility under the enrollee's managed care plan, including an | ||
applicable copayment, coinsurance, or deductible. | ||
SECTION 2.09. Subchapter C, Chapter 1579, Insurance Code, | ||
is amended by adding Sections 1579.109 and 1579.110 to read as | ||
follows: | ||
Sec. 1579.109. EMERGENCY CARE COVERAGE. (a) In this | ||
section, "emergency care" has the meaning assigned by Section | ||
1301.155. | ||
(b) A managed care plan provided under this chapter must | ||
provide out-of-network emergency care coverage in accordance with | ||
this section. | ||
(c) The coverage must require the administrator of the plan | ||
to pay for emergency care performed for an enrollee by an | ||
out-of-network provider in an amount that the administrator | ||
determines is reasonable for the emergency care or at an agreed | ||
rate. | ||
(d) For the purposes of Subsection (c), an out-of-network | ||
provider may not bill an enrollee in, and the enrollee does not have | ||
financial responsibility for, an amount greater than the enrollee's | ||
responsibility under the enrollee's managed care plan, including an | ||
applicable copayment, coinsurance, or deductible. | ||
Sec. 1579.110. OUT-OF-NETWORK FACILITY-BASED PROVIDER | ||
COVERAGE. (a) In this section, "facility-based provider" means a | ||
physician or health care provider who provides health care services | ||
to patients of a health care facility. | ||
(b) A managed care plan provided under this chapter must | ||
provide out-of-network facility-based provider coverage in | ||
accordance with this section. | ||
(c) The coverage must require the administrator of the plan | ||
to pay for a health care service performed for an enrollee by an | ||
out-of-network provider who is a facility-based provider in an | ||
amount that the administrator determines is reasonable for the | ||
service or at an agreed rate if the provider performed the service | ||
at a health care facility that is a participating provider. | ||
(d) An out-of-network provider who is a facility-based | ||
provider may not bill an enrollee receiving a health care service | ||
described by Subsection (c) in, and the enrollee does not have | ||
financial responsibility for, an amount greater than the enrollee's | ||
responsibility under the enrollee's managed care plan, including an | ||
applicable copayment, coinsurance, or deductible. | ||
ARTICLE 3. MANDATORY MEDIATION REQUESTED BY PROVIDER, ISSUER, OR | ||
ADMINISTRATOR | ||
SECTION 3.01. Sections 1467.001(1), (3), (5), and (7), | ||
Insurance Code, are amended to read as follows: | ||
(1) "Administrator" means: | ||
(A) an administering firm for a health benefit | ||
plan providing coverage under Chapter 1551, 1575, or 1579; [ |
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(B) if applicable, the claims administrator for | ||
the health benefit plan; and | ||
(C) if applicable, an administrating firm for an | ||
eligible plan for which an election is made under Section | ||
1276.0002. | ||
(3) "Enrollee" means an individual who is eligible to | ||
receive benefits through a [ |
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health benefit plan subject to this chapter [ |
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(5) "Mediation" means a process in which an impartial | ||
mediator facilitates and promotes agreement between the health | ||
[ |
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administrator and a facility-based provider or emergency care | ||
provider or the provider's representative to settle a health | ||
benefit claim of an enrollee. | ||
(7) "Party" means a health benefit plan issuer [ |
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administrator, or a facility-based provider or emergency care | ||
provider or the provider's representative who participates in a | ||
mediation conducted under this chapter. [ |
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SECTION 3.02. Sections 1467.002 and 1467.005, Insurance | ||
Code, are amended to read as follows: | ||
Sec. 1467.002. APPLICABILITY OF CHAPTER. This chapter | ||
applies to: | ||
(1) a health benefit plan offered by a health | ||
maintenance organization operating under Chapter 843; | ||
(2) a preferred provider benefit plan, including an | ||
exclusive provider benefit plan, offered by an insurer under | ||
Chapter 1301; and | ||
(3) [ |
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other than a health maintenance organization plan, under Chapter | ||
1551, 1575, or 1579 or of an eligible plan for which an election is | ||
made under Section 1276.0002. | ||
Sec. 1467.005. REFORM. This chapter may not be construed to | ||
prohibit: | ||
(1) a health [ |
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offering a reformed claim settlement; or | ||
(2) a facility-based provider or emergency care | ||
provider from, at any time, offering a reformed charge for health | ||
care or medical services or supplies. | ||
SECTION 3.03. Sections 1467.051(a) and (b), Insurance Code, | ||
are amended to read as follows: | ||
(a) A facility-based provider, emergency care provider, | ||
health benefit plan issuer, or administrator [ |
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request mediation of a settlement of an out-of-network health | ||
benefit claim if: | ||
(1) the amount charged by the provider and unpaid by | ||
the issuer or administrator [ |
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copayments, deductibles, and coinsurance, [ |
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(2) the health benefit claim is for: | ||
(A) emergency care; or | ||
(B) a health care or medical service or supply | ||
provided by a facility-based provider in a facility that is a | ||
preferred provider or that has a contract with the administrator. | ||
(b) If a person [ |
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facility-based provider or emergency care provider, or the | ||
provider's representative, and the health benefit plan issuer | ||
[ |
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in the mediation. | ||
SECTION 3.04. Section 1467.052(c), Insurance Code, is | ||
amended to read as follows: | ||
(c) A person may not act as mediator for a claim settlement | ||
dispute if the person has been employed by, consulted for, or | ||
otherwise had a business relationship with a health benefit plan | ||
issuer or administrator of a health [ |
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a physician, health care practitioner, or other health care | ||
provider during the three years immediately preceding the request | ||
for mediation. | ||
SECTION 3.05. Section 1467.053(d), Insurance Code, is | ||
amended to read as follows: | ||
(d) The mediator's fees shall be split evenly and paid by | ||
the health benefit plan issuer [ |
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facility-based provider or emergency care provider. | ||
SECTION 3.06. Sections 1467.054(a), (b), (c), and (d), | ||
Insurance Code, are amended to read as follows: | ||
(a) A facility-based provider, emergency care provider, | ||
health benefit plan issuer, or administrator [ |
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request mandatory mediation under this subchapter [ |
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(b) A request for mandatory mediation must be provided to | ||
the department on a form prescribed by the commissioner and must | ||
include: | ||
(1) the name of the person [ |
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mediation; | ||
(2) a brief description of the claim to be mediated; | ||
(3) contact information, including a telephone | ||
number, for the requesting person [ |
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[ |
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(4) the name of the facility-based provider or | ||
emergency care provider and name of the health benefit plan issuer | ||
[ |
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(5) any other information the commissioner may require | ||
by rule. | ||
(c) On receipt of a request for mediation, the department | ||
shall notify, as applicable, the facility-based provider or | ||
emergency care provider and health benefit plan issuer [ |
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administrator of the request. | ||
(d) In an effort to settle the claim before mediation, all | ||
parties must participate in an informal settlement teleconference | ||
not later than the 30th day after the date on which a person [ |
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[ |
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SECTION 3.07. Section 1467.055(g), Insurance Code, is | ||
amended to read as follows: | ||
(g) A [ |
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shall be held not later than the 180th day after the date of the | ||
request for mediation. | ||
SECTION 3.08. Sections 1467.056(a), (b), and (d), Insurance | ||
Code, are amended to read as follows: | ||
(a) In a mediation under this subchapter [ |
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parties shall[ |
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[ |
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(1) [ |
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provider or emergency care provider for the health care or medical | ||
service or supply is excessive; and | ||
(2) [ |
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issuer [ |
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[ |
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service or supply or is unreasonably low[ |
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[ |
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(b) The facility-based provider or emergency care provider | ||
may present information regarding the amount charged for the health | ||
care or medical service or supply. The health benefit plan issuer | ||
[ |
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amount paid by the issuer [ |
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(d) The goal of the mediation is to reach an agreement among | ||
[ |
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provider[ |
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administrator, as applicable, as to the amount paid by the issuer | ||
[ |
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emergency care provider and[ |
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facility-based provider or emergency care provider[ |
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SECTION 3.09. Sections 1467.058 and 1467.059, Insurance | ||
Code, are amended to read as follows: | ||
Sec. 1467.058. CONTINUATION OF MEDIATION. After a referral | ||
is made under Section 1467.057, the facility-based provider or | ||
emergency care provider and the health benefit plan issuer | ||
[ |
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further determine their responsibilities. [ |
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Sec. 1467.059. MEDIATION AGREEMENT. The mediator shall | ||
prepare a confidential mediation agreement and order that states[ |
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[ |
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[ |
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Section 1467.058. | ||
SECTION 3.10. Section 1467.101(a), Insurance Code, is | ||
amended to read as follows: | ||
(a) The following conduct constitutes bad faith mediation | ||
for purposes of this chapter: | ||
(1) failing to participate in the mediation; | ||
(2) failing to provide information the mediator | ||
believes is necessary to facilitate an agreement; [ |
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(3) failing to designate a representative | ||
participating in the mediation with full authority to enter into | ||
any mediated agreement; or | ||
(4) failing to appear for mediation. | ||
SECTION 2.11. Section 1467.151(b), Insurance Code, is | ||
amended to read as follows: | ||
(b) The department and the Texas Medical Board or other | ||
appropriate regulatory agency shall maintain information: | ||
(1) on each complaint filed that concerns a claim or | ||
mediation subject to this chapter; and | ||
(2) related to a claim that is the basis of an enrollee | ||
complaint, including: | ||
(A) the type of services that gave rise to the | ||
dispute; | ||
(B) the type and specialty, if any, of the | ||
facility-based provider or emergency care provider who provided the | ||
out-of-network service; | ||
(C) the county and metropolitan area in which the | ||
health care or medical service or supply was provided; | ||
(D) whether the health care or medical service or | ||
supply was for emergency care; and | ||
(E) any other information about: | ||
(i) the health benefit plan issuer | ||
[ |
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or | ||
(ii) the facility-based provider or | ||
emergency care provider that the Texas Medical Board or other | ||
appropriate regulatory agency by rule requires. | ||
ARTICLE 4. CONFORMING AMENDMENTS | ||
SECTION 4.01. Sections 1456.002(a) and (c), Insurance Code, | ||
are amended to read as follows: | ||
(a) This chapter applies to any health benefit plan that: | ||
(1) provides benefits for medical or surgical expenses | ||
incurred as a result of a health condition, accident, or sickness, | ||
including an individual, group, blanket, or franchise insurance | ||
policy or insurance agreement, a group hospital service contract, | ||
or an individual or group evidence of coverage that is offered by: | ||
(A) an insurance company; | ||
(B) a group hospital service corporation | ||
operating under Chapter 842; | ||
(C) a fraternal benefit society operating under | ||
Chapter 885; | ||
(D) a stipulated premium company operating under | ||
Chapter 884; | ||
(E) [ |
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[ |
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that holds a certificate of authority under Chapter 846; | ||
(F) [ |
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corporation that holds a certificate of authority under Chapter | ||
844; or | ||
(G) [ |
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code or another insurance law of this state that contracts directly | ||
for health care services on a risk-sharing basis, including a | ||
capitation basis; or | ||
(2) provides health and accident coverage through a | ||
risk pool created under Chapter 172, Local Government Code, | ||
notwithstanding Section 172.014, Local Government Code, or any | ||
other law. | ||
(c) This chapter does not apply to: | ||
(1) Medicaid managed care programs operated under | ||
Chapter 533, Government Code; | ||
(2) Medicaid programs operated under Chapter 32, Human | ||
Resources Code; [ |
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(3) the state child health plan operated under Chapter | ||
62 or 63, Health and Safety Code; or | ||
(4) a health benefit plan subject to Section 1271.155, | ||
1301.164, 1551.229, 1575.172, or 1579.110, or an eligible plan for | ||
which an election is made under Section 1276.0002. | ||
SECTION 4.02. The following provisions of the Insurance | ||
Code are repealed: | ||
(1) Sections 1467.051(c) and (d); | ||
(2) Section 1467.0511; | ||
(3) Sections 1467.054(f) and (g); | ||
(4) Section 1467.055(d); and | ||
(5) Section 1467.151(d). | ||
ARTICLE 5. TRANSITION AND EFFECTIVE DATE | ||
SECTION 5.01. The changes in law made by this Act apply only | ||
to a health care or medical service or supply provided on or after | ||
the effective date of this Act. A health care or medical service or | ||
supply provided before the effective date of this Act 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 4.02. This Act takes effect September 1, 2019. |