Texas 2019 - 86th Regular

Texas House Bill HB3828 Compare Versions

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

Old	New	Differences
1	1	86R13776 SCL-D
2	2	By: Sherman, Sr. H.B. No. 3828
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the disclosure of health benefit plan network status of
8	8	certain physicians and health care practitioners.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 843.348, Insurance Code, is amended by
11	11	adding Subsection (e-1) to read as follows:
12	12	(e-1) If the health maintenance organization considers
13	13	proposed medical care or health care services elective and requires
14	14	preauthorization as a condition of payment under the health benefit
15	15	plan, the health maintenance organization shall, at the time the
16	16	health maintenance organization issues a determination
17	17	preauthorizing the services, provide to the enrollee a statement of
18	18	the network status of any facility-based physician or health care
19	19	provider that the health maintenance organization reasonably
20	20	expects will provide and bill for any of the authorized services.
21	21	SECTION 2. Section 1301.135, Insurance Code, is amended by
22	22	adding Subsection (d-1) to read as follows:
23	23	(d-1) If an insurer considers proposed medical care or
24	24	health care services elective and requires preauthorization as a
25	25	condition of payment under the policy, the insurer shall, at the
26	26	time the insurer issues a determination preauthorizing the
27	27	services, provide to the insured a statement of the network status
28	28	of any facility-based physician or health care provider that the
29	29	insurer reasonably expects will provide and bill for any of the
30	30	authorized services.
31	31	SECTION 3. Chapter 159, Occupations Code, is amended by
32	32	adding Section 159.012 to read as follows:
33	33	Sec. 159.012. DISCLOSURE OF OTHER PHYSICIAN OR HEALTH CARE
34	34	PRACTITIONER. If, for a nonemergency service, a physician
35	35	schedules another physician or health care practitioner to
36	36	otherwise treat the patient or prospective patient, the physician
37	37	shall provide to the patient a written disclosure form prescribed
38	38	by the board that includes:
39	39	(1) a statement that the physician is scheduling
40	40	another physician or health care practitioner to provide services
41	41	and that the other physician or practitioner may not be in the
42	42	patient's provider network; and
43	43	(2) the other physician's or health care
44	44	practitioner's name, medical or health care practice name, practice
45	45	specialty, address, and telephone number.
46	46	SECTION 4. (a) Sections 843.348 and 1301.135, Insurance
47	47	Code, as amended by this Act, apply only to a health benefit plan
48	48	that is delivered, issued for delivery, or renewed on or after
49	49	January 1, 2020. A health benefit plan delivered, issued for
50	50	delivery, or renewed before January 1, 2020, is governed by the law
51	51	as it existed immediately before the effective date of this Act, and
52	52	that law is continued in effect for that purpose.
53	53	(b) Section 159.012, Occupations Code, as added by this Act,
54	54	applies only to a health care service scheduled on or after the
55	55	effective date of this Act.
56	56	SECTION 5. This Act takes effect September 1, 2019.