| 1 | 1 | | 85R9192 LED-F |
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| 2 | 2 | | By: Metcalf H.B. No. 4194 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to notice of health benefit plan provider network status |
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| 8 | 8 | | for certain facility-based physicians. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. The heading to Section 1456.004, Insurance Code, |
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| 11 | 11 | | is amended to read as follows: |
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| 12 | 12 | | Sec. 1456.004. REQUIRED DISCLOSURES [DISCLOSURE]: |
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| 13 | 13 | | FACILITY-BASED PHYSICIANS. |
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| 14 | 14 | | SECTION 2. Section 1456.004, Insurance Code, is amended by |
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| 15 | 15 | | adding Subsection (d) to read as follows: |
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| 16 | 16 | | (d) At least 48 hours before an enrollee's scheduled arrival |
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| 17 | 17 | | at a health care facility for an elective nonemergency service, a |
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| 18 | 18 | | facility-based physician who is to perform or assist in performing |
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| 19 | 19 | | the service shall notify the enrollee if the facility-based |
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| 20 | 20 | | physician is not within the enrollee's health benefit plan provider |
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| 21 | 21 | | network. |
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| 22 | 22 | | SECTION 3. Section 1456.004, Insurance Code, as amended by |
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| 23 | 23 | | this Act, applies only to a service provided on or after September |
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| 24 | 24 | | 3, 2017. A service provided before September 3, 2017, is governed |
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| 25 | 25 | | by the law as it existed immediately before the effective date of |
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| 26 | 26 | | this Act, and that law is continued in effect for that purpose. |
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| 27 | 27 | | SECTION 4. This Act takes effect September 1, 2017. |
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