84R8631 SCL-D
By: Elkins H.B. No. 4096
A BILL TO BE ENTITLED
AN ACT
relating to the establishment of a pilot program for the electronic
transmission of certain subrogation claims.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle A, Title 8, Insurance Code, is amended
by adding Chapter 1222 to read as follows:
CHAPTER 1222. MOTOR VEHICLE ACCIDENTS AND AUTOMOBILE INSURANCE
SUBROGATION PILOT PROGRAM
Sec. 1222.001. DEFINITIONS. In this chapter:
(1) "Automobile insurer" means an insurer writing
automobile insurance in this state, including an insurance company,
corporation, reciprocal or interinsurance exchange, mutual
insurance company, Lloyd's plan, county mutual insurance company,
or other insurer.
(2) "Enrollee" means an individual entitled to
benefits under a health benefit plan.
(3) "Health benefit plan issuer" means:
(A) a managed care organization issuing a managed
care plan offered under Chapter 533, Government Code;
(B) the Health and Human Services Commission or
another entity administering the state Medicaid program operated
under Chapter 32, Human Resources Code, or the state child health
plan or health benefits plan for children under Chapter 62 or 63,
Health and Safety Code;
(C) the Employees Retirement System of Texas or
another entity issuing or administering a basic coverage plan under
Chapter 1551;
(D) the Teacher Retirement System of Texas or
another entity issuing or administering a basic plan under Chapter
1575 or a primary care coverage plan under Chapter 1579; and
(E) The Texas A&M University System or The
University of Texas System or another entity issuing or
administering basic coverage under Chapter 1601.
(4) "Payor" means a health benefit plan issuer who:
(A) pays benefits to or on behalf of an enrollee
as a result of personal injuries to the enrollee caused by the
tortious conduct of a third party; and
(B) has a contractual or statutory right of
subrogation for the benefits paid.
Sec. 1222.002. PILOT PROGRAM. (a) The department shall
establish a pilot program to evaluate the benefits of using an
electronic records management system to collect and transmit
information related to injuries arising from motor vehicle
accidents to facilitate identification of potential subrogation
claims and collection of amounts owed.
(b) Subject to the availability of funds, the department
shall contract with an organization to operate the pilot program.
The department shall select the organization to serve as the
contractor using competitive bidding.
(c) A payor shall provide the contractor with the
information required by the contractor related to benefits paid for
injuries arising from motor vehicle accidents in this state. Each
automobile insurer shall provide the contractor with the
information required by the contractor related to motor vehicle
accidents in this state. The contractor shall use the information
provided under this subsection to determine if the payor has a right
of subrogation against an automobile insurer and, where
appropriate, seek recovery of the amounts owed on behalf of the
payor.
(d) The contractor shall report the results of the
subrogation determination and subrogation claim to the payor and
provide any funds recovered to the payor.
Sec. 1222.003. CONFIDENTIALITY. The contractor operating
the pilot program shall maintain the confidentiality of all
information provided to the contractor by a payor under this
chapter and may use the information only for the purposes of the
pilot program.
Sec. 1222.004. EVALUATION AND REPORT. Not later than
December 1, 2016, the department shall submit a report to the
speaker of the house of representatives, lieutenant governor, and
appropriate standing committees of the legislature that includes:
(1) the cost of the pilot program operated under this
chapter;
(2) the amount of money collected under the pilot
program on behalf of payors; and
(3) an evaluation of the effectiveness of the pilot
program.
Sec. 1222.005. EXPIRATION. This chapter expires September
1, 2017.
SECTION 2. This Act takes effect September 1, 2015.