84R1278 AJA-D
By: Zedler H.B. No. 761
A BILL TO BE ENTITLED
AN ACT
relating to the payment for services provided by certain types of
health care practitioners under contracts between the
practitioners and managed care health benefit plans.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter C, Chapter 1451, Insurance Code, is
amended by adding Section 1451.1041 to read as follows:
Sec. 1451.1041. NONDISCRIMINATORY PAYMENT OF NETWORK
PRACTITIONERS. (a) In this section, "managed care plan" means a
plan under which a health maintenance organization, preferred
provider benefit plan issuer, or other organization provides or
arranges for health care benefits to plan participants and requires
or encourages plan participants to use health care practitioners
the plan designates.
(b) In entering into contracts for the provision of health
care services to managed care plan participants by health care
practitioners eligible to be selected under this subchapter, the
issuer of a managed care plan may not differentiate among those
types of practitioners in the amount to be paid by the plan issuer,
or the method to be used by the plan issuer to compute the amount to
be paid by the plan issuer, for the performance of a covered
physical modality or procedure that is within the scope of the
license of more than one of those types of practitioners.
SECTION 2. The change in law made by this Act applies only
to contracts entered into or renewed on or after the effective date
of this Act.
SECTION 3. This Act takes effect September 1, 2015.