83R4971 AJA-F
By: Thompson of Harris H.B. No. 979
A BILL TO BE ENTITLED
AN ACT
relating to reimbursement under preferred provider benefit plans
for services provided by licensed podiatrists.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 1301.062, Insurance Code, is amended to
read as follows:
Sec. 1301.062. PREFERRED PROVIDER CONTRACTS BETWEEN
INSURERS AND PODIATRISTS. (a) In this section, "podiatrist" means
a podiatrist licensed by the Texas State Board of Podiatric Medical
Examiners under Chapter 202, Occupations Code.
(b) A preferred provider contract between an insurer and a
podiatrist [licensed by the Texas State Board of Podiatric Medical
Examiners] must provide that:
(1) the podiatrist may request a copy of the coding
guidelines and payment schedules applicable to the compensation
that the podiatrist will receive under the contract for services;
(2) the insurer shall provide a copy of the coding
guidelines and payment schedules not later than the 30th day after
the date of the podiatrist's request;
(3) the insurer may not unilaterally make material
retroactive revisions to the coding guidelines and payment
schedules; [and]
(4) the podiatrist may, practicing within the scope of
the law regulating podiatry, furnish x-rays and nonprefabricated
orthotics covered by the health insurance policy; and
(5) the methodology used to compute the amount of
payment or reimbursement for services or procedures covered by the
contract is the same as the methodology used to compute the amount
of payment or reimbursement when the services or procedures are
provided by a physician.
SECTION 2. The change in law made by this Act applies only
to a preferred provider contract entered into or renewed on or after
January 1, 2014. A contract entered into or renewed before January
1, 2014, is governed by the law applicable to the contract
immediately before the effective date of this Act, and that law is
continued in effect for that purpose.
SECTION 3. This Act takes effect September 1, 2013.