Texas 2009 - 81st Regular

Texas House Bill HB4095 Compare Versions

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Old	New	Differences
1	1	81R13403 KCR-F
2	2	By: Eiland H.B. No. 4095
3	3	Substitute the following for H.B. No. 4095:
4	4	By: Eiland C.S.H.B. No. 4095
5	5
6	6
7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to the recovery from third parties by health benefit plan
10	10	issuers.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Subtitle A, Title 8, Insurance Code, is amended
13	13	by adding Chapter 1220 to read as follows:
14	14	CHAPTER 1220. HEALTH BENEFIT PLAN ISSUER'S RECOVERY FROM THIRD
15	15	PARTIES
16	16	Sec. 1220.001. DEFINITION. In this chapter, "health
17	17	benefit plan" means a plan that provides benefits for medical or
18	18	surgical expenses incurred as a result of a health condition,
19	19	accident, or sickness, including an individual, group, blanket, or
20	20	franchise insurance policy or insurance agreement, a group hospital
21	21	service contract, or an individual or group evidence of coverage or
22	22	similar coverage document. The term includes, to the extent
23	23	allowed by other law, a plan described by 29 U.S.C. Section 1003(b).
24	24	Sec. 1220.002. RECOVERY FROM THIRD PARTIES. (a) A health
25	25	benefit plan that provides that the plan issuer has a right of
26	26	recovery from a third party for injury suffered by a covered
27	27	individual, whether by subrogation, reassignment, or
28	28	reimbursement:
29	29	(1) must provide that the right of recovery is
30	30	subordinate to the covered individual's right to be fully
31	31	compensated for damages incurred; and
32	32	(2) must obligate the plan issuer to share in the legal
33	33	expenses incurred by the covered individual in obtaining recovery
34	34	from a third party to the same extent that the issuer shares in any
35	35	recovery from the third party.
36	36	(b) The health benefit plan issuer may not pursue a right of
37	37	subrogation against a covered individual's first party coverage.
38	38	SECTION 2. The change in law made by this Act applies only
39	39	to a health benefit plan that is delivered, issued for delivery, or
40	40	renewed on or after January 1, 2010. A health benefit plan that is
41	41	delivered, issued for delivery, or renewed before January 1, 2010,
42	42	is covered by the law in effect at the time the health benefit plan
43	43	was delivered, issued for delivery, or renewed, and that law is
44	44	continued in effect for that purpose.
45	45	SECTION 3. This Act takes effect September 1, 2009.