Texas 2019 - 86th Regular

Texas House Bill HB2632 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		86R24398 JES-D
2		-	By: J. Johnson of Dallas, Oliverson, Guillen, H.B. No. 2632
3		-	et al.
	2	+	By: J. Johnson of Dallas, Oliverson, et al. H.B. No. 2632
	3	+	Substitute the following for H.B. No. 2632:
	4	+	By: Lucio III C.S.H.B. No. 2632
4	5
5	6
6	7		A BILL TO BE ENTITLED
7	8		AN ACT
8	9		relating to notice by certain managed care entities of changes
9	10		related to reimbursements applicable to certain physicians and
10	11		health care providers.
11	12		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	13		SECTION 1. Section 843.321, Insurance Code, is amended by
13	14		adding Subsection (a-1) to read as follows:
14	15		(a-1) A health maintenance organization or health
15	16		maintenance organization's agent that provides a notice under
16	17		Subsection (a)(3) must provide the notice to a physician or
17	18		provider, including a licensed clinical social worker, in a manner
18	19		that is trackable and indicates the date and time the notice was
19	20		sent, including:
20	21		(1) by certified mail, return receipt requested, to
21	22		the physician's or provider's address; or
22	23		(2) by e-mail to an e-mail address specified by the
23	24		physician or provider.
24	25		SECTION 2. Section 1301.136, Insurance Code, is amended by
25	26		adding Subsection (a-1) to read as follows:
26	27		(a-1) An insurer or insurer's agent that provides a notice
27	28		under Subsection (a)(3) must provide the notice to a preferred
28	29		provider, including a licensed clinical social worker, in a manner
29	30		that is trackable and indicates the date and time the notice was
30	31		sent, including:
31	32		(1) by certified mail, return receipt requested, to
32	33		the preferred provider's address; or
33	34		(2) by e-mail to an e-mail address specified by the
34	35		preferred provider.
35	36		SECTION 3. The heading to Chapter 1453, Insurance Code, is
36	37		amended to read as follows:
37	38		CHAPTER 1453. DISCLOSURE OF REIMBURSEMENT GUIDELINES AND AMOUNTS
38	39		UNDER MANAGED CARE PLAN
39	40		SECTION 4. Section 1453.001(1), Insurance Code, is amended
40	41		to read as follows:
41	42		(1) "Health care provider" means:
42	43		(A) a hospital, emergency clinic, outpatient
43	44		clinic, or other facility providing health care services; or
44	45		(B) an individual who is licensed in this state
45	46		to provide health care services, including a physician who is
46	47		licensed to practice medicine in this state.
47	48		SECTION 5. Chapter 1453, Insurance Code, is amended by
48	49		adding Section 1453.004 to read as follows:
49	50		Sec. 1453.004. NOTICE OF CHANGE TO REIMBURSEMENT AMOUNT.
50	51		(a) A managed care entity shall provide to each health care
51	52		provider, including a licensed clinical social worker, under
52	53		contract with the managed care entity notice of any change to a
53	54		reimbursement amount that will be paid to the health care provider
54	55		for a good or service provided by the health care provider. The
55	56		notice must be provided before the effective date of the change.
56	57		(b) The notice required by this section must be sent:
57	58		(1) directly to each health care provider that may be
58	59		affected by the reimbursement amount change; and
59	60		(2) in a manner that is trackable and indicates the
60	61		date and time the notice was sent, including:
61	62		(A) by certified mail, return receipt requested,
62	63		to the provider's address; or
63	64		(B) by e-mail to an e-mail address specified by
64	65		the provider.
65	66		SECTION 6. This Act takes effect September 1, 2019.