1 | 1 | | 81R9616 AJA-D |
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2 | 2 | | By: Smithee H.B. No. 2576 |
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3 | 3 | | |
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4 | 4 | | |
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5 | 5 | | A BILL TO BE ENTITLED |
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6 | 6 | | AN ACT |
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7 | 7 | | relating to direct payment by a health or automobile insurer of |
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8 | 8 | | physicians and health care providers. |
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9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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10 | 10 | | SECTION 1. The heading of Subchapter B, Chapter 1204, |
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11 | 11 | | Insurance Code, is amended to read as follows: |
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12 | 12 | | SUBCHAPTER B. ASSIGNMENT OF BENEFIT PAYMENTS; DIRECT PAYMENT OF |
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13 | 13 | | BENEFITS |
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14 | 14 | | SECTION 2. Subchapter B, Chapter 1204, Insurance Code, is |
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15 | 15 | | amended by adding Sections 1204.056, 1204.057, and 1204.058 to read |
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16 | 16 | | as follows: |
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17 | 17 | | Sec. 1204.056. ASSIGNMENT OF BENEFITS OPTION REQUIRED. |
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18 | 18 | | (a) A health insurance policy claim form must provide an option |
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19 | 19 | | for the claimant to assign benefits to a physician or health care |
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20 | 20 | | provider who provided covered services. For purposes of this |
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21 | 21 | | subchapter, "health care provider" includes a licensed provider of |
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22 | 22 | | ambulance services. |
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23 | 23 | | (b) The health insurer may require a written attestation of |
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24 | 24 | | assignment of benefits. |
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25 | 25 | | Sec. 1204.057. AMOUNT OF PAYMENT UNDER ASSIGNMENT OF |
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26 | 26 | | BENEFITS. A payment to a physician or health care provider under an |
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27 | 27 | | assignment of benefits may not be more than the amount the insurer |
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28 | 28 | | would have paid in the absence of an assignment of benefits. |
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29 | 29 | | Sec. 1204.058. DIRECT PAYMENT PROVISION AUTHORIZED. A |
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30 | 30 | | health insurance policy may provide for payment of benefits |
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31 | 31 | | directly to a physician or health care provider who provides |
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32 | 32 | | covered services to a covered person, even in the absence of an |
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33 | 33 | | assignment of benefits. |
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34 | 34 | | SECTION 3. Subchapter B, Chapter 1301, Insurance Code, is |
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35 | 35 | | amended by adding Section 1301.0561 to read as follows: |
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36 | 36 | | Sec. 1301.0561. DIRECT PAYMENT OF PREFERRED PROVIDERS |
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37 | 37 | | REQUIRED. An insurer that issues a preferred provider benefit plan |
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38 | 38 | | shall pay a preferred provider directly for covered services |
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39 | 39 | | provided to a person insured under the plan, in accordance with this |
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40 | 40 | | chapter, without requiring an assignment of benefits. |
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41 | 41 | | SECTION 4. Subtitle C, Title 10, Insurance Code, is amended |
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42 | 42 | | by adding Chapter 1955 to read as follows: |
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43 | 43 | | CHAPTER 1955. PAYMENT OF CERTAIN BENEFITS UNDER AUTOMOBILE |
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44 | 44 | | INSURANCE POLICY |
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45 | 45 | | Sec. 1955.001. APPLICABILITY OF CHAPTER. This chapter |
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46 | 46 | | applies to an insurer writing automobile insurance in this state, |
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47 | 47 | | including an insurance company, corporation, reciprocal or |
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48 | 48 | | interinsurance exchange, mutual insurance company, association, |
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49 | 49 | | Lloyd's plan, or other insurer. |
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50 | 50 | | Sec. 1955.002. ASSIGNMENT OF BENEFITS OPTION REQUIRED. An |
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51 | 51 | | automobile insurance policy claim form must provide an option for |
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52 | 52 | | the claimant to assign benefits to an ambulance service provider |
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53 | 53 | | who provides services covered under the policy in connection with |
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54 | 54 | | an occurrence covered by the policy. The automobile insurer may |
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55 | 55 | | require a written attestation of assignment of benefits. |
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56 | 56 | | Sec. 1955.003. DIRECT PAYMENT PROVISION AUTHORIZED. An |
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57 | 57 | | automobile insurance policy may provide for payment of benefits |
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58 | 58 | | directly to an ambulance service provider who provides services |
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59 | 59 | | covered under the policy in connection with an occurrence covered |
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60 | 60 | | by the policy, even in the absence of an assignment of benefits. |
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61 | 61 | | SECTION 5. The changes in law made by this Act apply only to |
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62 | 62 | | an insurance policy delivered, issued for delivery, or renewed on |
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63 | 63 | | or after January 1, 2010. An insurance policy delivered, issued for |
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64 | 64 | | delivery, or renewed before January 1, 2010, is governed by the law |
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65 | 65 | | in effect immediately before the effective date of this Act, and |
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66 | 66 | | that law is continued in effect for that purpose. |
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67 | 67 | | SECTION 6. This Act takes effect September 1, 2009. |
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