84R14716 T
By: Coleman H.B. No. 3006
A BILL TO BE ENTITLED
AN ACT
Relating to certain penalties paid to the Texas Health Insurance
Risk Pool.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 843.342(m), Insurance Code, is amended
to read as follows:
(m) Notwithstanding any other provision of this section,
this subsection governs the payment of a penalty under this
section. For a penalty under this section relating to a clean claim
submitted by a physician or provider other than an institutional
provider, the health maintenance organization shall pay the entire
penalty to the physician or provider, except for any interest
computed under Subsection (c), which shall be paid to the Texas
Health Insurance Risk Pool. [For a penalty under this section
relating to a clean claim submitted by an institutional provider,
the health maintenance organization shall pay 50 percent of the
total penalty amount computed under this section, including
interest, to the institutional provider and the remaining 50
percent of that amount to the Texas Health Insurance Risk Pool.]
SECTION 2. Section 1301.137(l), Insurance Code, is amended
to read as follows:
(l) Notwithstanding any other provision of this section,
this subsection governs the payment of a penalty under this
section. For a penalty under this section relating to a clean claim
submitted by a preferred provider other than an institutional
provider, the insurer shall pay the entire penalty to the preferred
provider, except for any interest computed under Subsection (c),
which shall be paid to the Texas Health Insurance Risk Pool. [For a
penalty under this section relating to a clean claim submitted by an
institutional provider, the insurer shall pay 50 percent of the
penalty amount computed under this section, including interest, to
the institutional provider and the remaining 50 percent of that
amount to the Texas Health Insurance Risk Pool.]
SECTION 3. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect on September 1, 2015.
SECTION 4. The importance of this legislation and the
crowded condition of the calendars in both houses create an
emergency and an imperative public necessity that the
constitutional rule requiring bills to be read on three separate
days in each house be suspended, and this rule hereby suspended, and
that this act take effect and be in force from and after its
passage, and it so enacted.