| 1 | 1 | | 81R8494 PB-F |
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| 2 | 2 | | By: Jackson, Mike S.B. No. 1751 |
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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 reimbursement under preferred provider benefit plans |
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| 8 | 8 | | for services provided by licensed podiatrists. |
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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. Section 1301.062, Insurance Code, is amended to |
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| 11 | 11 | | read as follows: |
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| 12 | 12 | | Sec. 1301.062. PREFERRED PROVIDER CONTRACTS BETWEEN |
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| 13 | 13 | | INSURERS AND PODIATRISTS. (a) In this section, "podiatrist" means |
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| 14 | 14 | | a podiatrist licensed by the Texas State Board of Podiatric Medical |
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| 15 | 15 | | Examiners under Chapter 202, Occupations Code. |
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| 16 | 16 | | (b) A preferred provider contract between an insurer and a |
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| 17 | 17 | | podiatrist [licensed by the Texas State Board of Podiatric Medical |
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| 18 | 18 | | Examiners] must provide that: |
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| 19 | 19 | | (1) the podiatrist may request a copy of the coding |
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| 20 | 20 | | guidelines and payment schedules applicable to the compensation |
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| 21 | 21 | | that the podiatrist will receive under the contract for services; |
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| 22 | 22 | | (2) the insurer shall provide a copy of the coding |
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| 23 | 23 | | guidelines and payment schedules not later than the 30th day after |
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| 24 | 24 | | the date of the podiatrist's request; |
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| 25 | 25 | | (3) the insurer may not unilaterally make material |
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| 26 | 26 | | retroactive revisions to the coding guidelines and payment |
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| 27 | 27 | | schedules; [and] |
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| 28 | 28 | | (4) the podiatrist may, practicing within the scope of |
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| 29 | 29 | | the law regulating podiatry, furnish x-rays and nonprefabricated |
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| 30 | 30 | | orthotics covered by the health insurance policy; and |
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| 31 | 31 | | (5) the methodology used to compute the amount of |
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| 32 | 32 | | payment or reimbursement for services or procedures covered by the |
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| 33 | 33 | | contract is the same as the methodology used to compute the amount |
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| 34 | 34 | | of payment or reimbursement when the services or procedures are |
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| 35 | 35 | | provided by a physician. |
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| 36 | 36 | | SECTION 2. This Act applies only to a preferred provider |
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| 37 | 37 | | contract entered into or renewed on or after January 1, 2010. A |
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| 38 | 38 | | contract entered into or renewed before January 1, 2010, is |
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| 39 | 39 | | governed by the law as it existed immediately before the effective |
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| 40 | 40 | | date of this Act, and that law is continued in effect for that |
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| 41 | 41 | | purpose. |
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| 42 | 42 | | SECTION 3. This Act takes effect September 1, 2009. |
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