Texas 2017 - 85th Regular

Texas House Bill HB2077 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	85R8865 PMO-D
2	2	By: Bonnen of Galveston H.B. No. 2077
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to data collection related to certain health benefit plan
8	8	issuers' calculation of payments to out-of-network physicians and
9	9	providers.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Chapter 38, Insurance Code, is amended by adding
12	12	Subchapter J to read as follows:
13	13	SUBCHAPTER J. DATA COLLECTION RELATED TO PAYMENT OF OUT-OF-NETWORK
14	14	PHYSICIANS AND HEALTH CARE PROVIDERS
15	15	Sec. 38.451. APPLICABILITY. This subchapter applies to an
16	16	issuer of a preferred provider benefit plan as defined by Section
17	17	1301.001 or an evidence of coverage for a health care plan that
18	18	provides basic health care services as defined by Section 843.002.
19	19	Sec. 38.452. DEFINITION. In this subchapter,
20	20	"out-of-network physicians and health care providers" means
21	21	physicians and health care providers who are not preferred
22	22	providers or are not otherwise included in a health benefit plan
23	23	issuer's delivery network.
24	24	Sec. 38.453. COLLECTION OF INFORMATION; REPORT. (a) A
25	25	health benefit plan issuer described by Section 38.451 shall report
26	26	biennially to the department the information required by the
27	27	commissioner under Subsection (b) relating to the health benefit
28	28	plan issuer's calculation of payment rates for and payments to
29	29	out-of-network physicians and health care providers.
30	30	(b) The commissioner by rule shall prescribe the form and
31	31	required content of the report required under Subsection (a). The
32	32	report must include payment methodologies and formulas used to
33	33	calculate payment rates for and payments to out-of-network
34	34	physicians and health care providers.
35	35	(c) On or before December 31 of each even-numbered year, the
36	36	commissioner shall assemble and analyze the information submitted
37	37	under this section during the preceding biennium and submit to the
38	38	speaker of the house of representatives, the lieutenant governor,
39	39	and the appropriate committees of each house of the legislature a
40	40	report of the information and the commissioner's analysis.
41	41	SECTION 2. Not later than December 31, 2017, the
42	42	commissioner of insurance shall adopt rules as necessary to
43	43	implement Subchapter J, Chapter 38, Insurance Code, as added by
44	44	this Act. The rules must require that a health benefit plan issuer
45	45	subject to that subchapter make the initial submission of data
46	46	under that subchapter not later than the 60th day after the
47	47	effective date of the rules.
48	48	SECTION 3. This Act takes effect September 1, 2017.