84R7543 MEW-D
By: Bonnen of Galveston H.B. No. 1691
A BILL TO BE ENTITLED
AN ACT
relating to prompt payment of certain physicians and health care
providers by a preferred provider benefit plan.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 1301.069, Insurance Code, is amended to
read as follows:
Sec. 1301.069. SERVICES PROVIDED BY CERTAIN PHYSICIANS AND
HEALTH CARE PROVIDERS. The provisions of this chapter relating to
prompt payment by an insurer of a physician or health care provider
and to verification of medical care or health care services apply to
a physician or provider who:
(1) is not a preferred provider included in the
preferred provider network; and
(2) provides to an insured:
(A) care related to an emergency or its attendant
episode of care as required by state or federal law; or
(B) specialty or other medical care or health
care services at the request of the insurer, [or] a preferred
provider, or an insured with out-of-network coverage [because the
services are not reasonably available from a preferred provider who
is included in the preferred delivery network].
SECTION 2. The change in law made by this Act applies only
to payment of a claim submitted to an insurer for payment on or
after January 1, 2016. A claim submitted before January 1, 2016, is
governed by the law as it existed 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, 2015.