85R7849 LED-D
By: Smithee H.B. No. 1428
A BILL TO BE ENTITLED
AN ACT
relating to mediation of the settlement of certain out-of-network
health benefit claims involving balance billing for members of the
Teacher Retirement System of Texas.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Sections 1467.001(1) and (3), Insurance Code,
are amended to read as follows:
(1) "Administrator" means:
(A) an administering firm for a health benefit
plan providing coverage under Chapter 1551, 1575, or 1579; and
(B) if applicable, the claims administrator for
the health benefit plan.
(3) "Enrollee" means an individual who is eligible to
receive benefits through a preferred provider benefit plan or a
health benefit plan under Chapter 1551, 1575, or 1579.
SECTION 2. Section 1467.002, Insurance Code, is amended to
read as follows:
Sec. 1467.002. APPLICABILITY OF CHAPTER. This chapter
applies to:
(1) a preferred provider benefit plan offered by an
insurer under Chapter 1301; and
(2) an administrator of a health benefit plan, other
than a health maintenance organization plan, under Chapter 1551,
1575, or 1579.
SECTION 3. The changes in law made by this Act apply only to
a health benefit claim for a medical service or supply provided on
or after January 1, 2018. A claim for a medical service or supply
provided before January 1, 2018, 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 4. This Act takes effect September 1, 2017.