Texas 2009 - 81st Regular

Texas Senate Bill SB1595 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	81R9616 AJA-D
2	2	By: Seliger S.B. No. 1595
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to direct payment by a health or automobile insurer of
8	8	physicians and health care providers.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. The heading of Subchapter B, Chapter 1204,
11	11	Insurance Code, is amended to read as follows:
12	12	SUBCHAPTER B. ASSIGNMENT OF BENEFIT PAYMENTS; DIRECT PAYMENT OF
13	13	BENEFITS
14	14	SECTION 2. Subchapter B, Chapter 1204, Insurance Code, is
15	15	amended by adding Sections 1204.056, 1204.057, and 1204.058 to read
16	16	as follows:
17	17	Sec. 1204.056. ASSIGNMENT OF BENEFITS OPTION REQUIRED.
18	18	(a) A health insurance policy claim form must provide an option
19	19	for the claimant to assign benefits to a physician or health care
20	20	provider who provided covered services. For purposes of this
21	21	subchapter, "health care provider" includes a licensed provider of
22	22	ambulance services.
23	23	(b) The health insurer may require a written attestation of
24	24	assignment of benefits.
25	25	Sec. 1204.057. AMOUNT OF PAYMENT UNDER ASSIGNMENT OF
26	26	BENEFITS. A payment to a physician or health care provider under an
27	27	assignment of benefits may not be more than the amount the insurer
28	28	would have paid in the absence of an assignment of benefits.
29	29	Sec. 1204.058. DIRECT PAYMENT PROVISION AUTHORIZED. A
30	30	health insurance policy may provide for payment of benefits
31	31	directly to a physician or health care provider who provides
32	32	covered services to a covered person, even in the absence of an
33	33	assignment of benefits.
34	34	SECTION 3. Subchapter B, Chapter 1301, Insurance Code, is
35	35	amended by adding Section 1301.0561 to read as follows:
36	36	Sec. 1301.0561. DIRECT PAYMENT OF PREFERRED PROVIDERS
37	37	REQUIRED. An insurer that issues a preferred provider benefit plan
38	38	shall pay a preferred provider directly for covered services
39	39	provided to a person insured under the plan, in accordance with this
40	40	chapter, without requiring an assignment of benefits.
41	41	SECTION 4. Subtitle C, Title 10, Insurance Code, is amended
42	42	by adding Chapter 1955 to read as follows:
43	43	CHAPTER 1955. PAYMENT OF CERTAIN BENEFITS UNDER AUTOMOBILE
44	44	INSURANCE POLICY
45	45	Sec. 1955.001. APPLICABILITY OF CHAPTER. This chapter
46	46	applies to an insurer writing automobile insurance in this state,
47	47	including an insurance company, corporation, reciprocal or
48	48	interinsurance exchange, mutual insurance company, association,
49	49	Lloyd's plan, or other insurer.
50	50	Sec. 1955.002. ASSIGNMENT OF BENEFITS OPTION REQUIRED. An
51	51	automobile insurance policy claim form must provide an option for
52	52	the claimant to assign benefits to an ambulance service provider
53	53	who provides services covered under the policy in connection with
54	54	an occurrence covered by the policy. The automobile insurer may
55	55	require a written attestation of assignment of benefits.
56	56	Sec. 1955.003. DIRECT PAYMENT PROVISION AUTHORIZED. An
57	57	automobile insurance policy may provide for payment of benefits
58	58	directly to an ambulance service provider who provides services
59	59	covered under the policy in connection with an occurrence covered
60	60	by the policy, even in the absence of an assignment of benefits.
61	61	SECTION 5. The changes in law made by this Act apply only to
62	62	an insurance policy delivered, issued for delivery, or renewed on
63	63	or after January 1, 2010. An insurance policy delivered, issued for
64	64	delivery, or renewed before January 1, 2010, is governed by the law
65	65	in effect immediately before the effective date of this Act, and
66	66	that law is continued in effect for that purpose.
67	67	SECTION 6. This Act takes effect September 1, 2009.