Texas 2019 - 86th Regular

Texas House Bill HB3299 Compare Versions

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

Old	New	Differences
1	1	86R8535 SMT-D
2	2	By: Lucio III H.B. No. 3299
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the applicability of mediation requirements for balance
8	8	billing to certain health benefit plans.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 1467.001, Insurance Code, is amended by
11	11	amending Subdivisions (1), (2-a), (2-b), and (3) and adding
12	12	Subdivision (2-c) to read as follows:
13	13	(1) "Administrator" means:
14	14	(A) an administering firm for a health benefit
15	15	plan providing coverage under Chapter 1551, 1575, or 1579; [and]
16	16	(B) if applicable, the claims administrator for
17	17	the health benefit plan; and
18	18	(C) if applicable, an administrating firm for an
19	19	eligible plan for which an election is made under Section
20	20	1467.0021.
21	21	(2-a) "Eligible plan" means a managed care plan that
22	22	is a self-funded or self-insured employee welfare benefit plan that
23	23	provides health benefits and is established in accordance with the
24	24	Employee Retirement Income Security Act of 1974 (29 U.S.C. Section
25	25	1001 et seq.).
26	26	(2-b) "Emergency care" has the meaning assigned by
27	27	Section 1301.155.
28	28	(2-c) [(2-b)] "Emergency care provider" means a
29	29	physician, health care practitioner, facility, or other health care
30	30	provider who provides and bills an enrollee, administrator, or
31	31	health benefit plan for emergency care.
32	32	(3) "Enrollee" means an individual who is eligible to
33	33	receive benefits through a [preferred provider benefit plan or a]
34	34	health benefit plan subject to this chapter [under Chapter 1551,
35	35	1575, or 1579].
36	36	SECTION 2. Section 1467.002, Insurance Code, is amended to
37	37	read as follows:
38	38	Sec. 1467.002. APPLICABILITY OF CHAPTER. This chapter
39	39	applies to:
40	40	(1) a preferred provider benefit plan offered by an
41	41	insurer under Chapter 1301; [and]
42	42	(2) an administrator of a health benefit plan, other
43	43	than a health maintenance organization plan, under Chapter 1551,
44	44	1575, or 1579; and
45	45	(3) an eligible plan for which the plan sponsor makes
46	46	an election under Section 1467.0021.
47	47	SECTION 3. Subchapter A, Chapter 1467, Insurance Code, is
48	48	amended by adding Section 1467.0021 to read as follows:
49	49	Sec. 1467.0021. ELECTIVE APPLICABILITY. (a) A plan
50	50	sponsor of an eligible plan may elect on an annual basis for this
51	51	chapter to apply to the plan. A sponsor making an election shall
52	52	provide written notice of the election to the department in the form
53	53	and manner required by department rule.
54	54	(b) An administrator of an eligible plan for which an
55	55	election is made under Subsection (a) shall ensure that the plan and
56	56	any evidence of coverage complies with this chapter.
57	57	SECTION 4. The Texas Department of Insurance shall adopt
58	58	rules necessary to implement Section 1467.0021, Insurance Code, as
59	59	added by this Act, not later than December 31, 2019.
60	60	SECTION 5. The changes in law made by this Act apply only to
61	61	a managed care plan that is delivered, issued for delivery, or
62	62	renewed on or after January 1, 2020. A managed care plan delivered,
63	63	issued for delivery, or renewed before January 1, 2020, is governed
64	64	by the law as it existed immediately before the effective date of
65	65	this Act, and that law is continued in effect for that purpose.
66	66	SECTION 6. This Act takes effect September 1, 2019.