Texas 2019 - 86th Regular

Texas Senate Bill SB1530 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		By: Hancock S.B. No. 1530
2		-	(Lucio III)
3	2
4	3
5	4		A BILL TO BE ENTITLED
6	5		AN ACT
7	6		relating to the applicability of mediation requirements for balance
8	7		billing to certain health benefit plans.
9	8		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	9		SECTION 1. Section 1467.001, Insurance Code, is amended by
11	10		amending Subdivisions (1), (2-a), (2-b), and (3) and adding
12	11		Subdivision (2-c) to read as follows:
13	12		(1) "Administrator" means:
14	13		(A) an administering firm for a health benefit
15	14		plan providing coverage under Chapter 1551, 1575, or 1579; [and]
16	15		(B) if applicable, the claims administrator for
17	16		the health benefit plan; and
18	17		(C) if applicable, an administrating firm for an
19	18		eligible plan for which an election is made under Section
20	19		1467.0021.
21	20		(2-a) "Eligible plan" means a managed care plan that
22	21		is a self-funded or self-insured employee welfare benefit plan that
23	22		provides health benefits and is established in accordance with the
24	23		Employee Retirement Income Security Act of 1974 (29 U.S.C. Section
25	24		1001 et seq.).
26	25		(2-b) "Emergency care" has the meaning assigned by
27	26		Section 1301.155.
28	27		(2-c) [(2-b)] "Emergency care provider" means a
29	28		physician, health care practitioner, facility, or other health care
30	29		provider who provides and bills an enrollee, administrator, or
31	30		health benefit plan for emergency care.
32	31		(3) "Enrollee" means an individual who is eligible to
33	32		receive benefits through a [preferred provider benefit plan or a]
34	33		health benefit plan subject to this chapter [under Chapter 1551,
35	34		1575, or 1579].
36	35		SECTION 2. Section 1467.002, Insurance Code, is amended to
37	36		read as follows:
38	37		Sec. 1467.002. APPLICABILITY OF CHAPTER. This chapter
39	38		applies to:
40	39		(1) a preferred provider benefit plan offered by an
41	40		insurer under Chapter 1301; [and]
42	41		(2) an administrator of a health benefit plan, other
43	42		than a health maintenance organization plan, under Chapter 1551,
44	43		1575, or 1579; and
45	44		(3) an eligible plan for which the plan sponsor makes
46	45		an election under Section 1467.0021.
47	46		SECTION 3. Subchapter A, Chapter 1467, Insurance Code, is
48	47		amended by adding Section 1467.0021 to read as follows:
49	48		Sec. 1467.0021. ELECTIVE APPLICABILITY. (a) A plan
50	49		sponsor of an eligible plan may elect on an annual basis for this
51	50		chapter to apply to the plan. A sponsor making an election shall
52	51		provide written notice of the election to the department in the form
53	52		and manner required by department rule.
54	53		(b) An administrator of an eligible plan for which an
55	54		election is made under Subsection (a) shall ensure that the plan and
56	55		any evidence of coverage complies with this chapter.
57	56		SECTION 4. The Texas Department of Insurance shall adopt
58	57		rules necessary to implement Section 1467.0021, Insurance Code, as
59	58		added by this Act, not later than August 31, 2021.
60	59		SECTION 5. The changes in law made by this Act apply only to
61	60		a managed care plan that is delivered, issued for delivery, or
62	61		renewed on or after September 1, 2021. A managed care plan
63	62		delivered, issued for delivery, or renewed before September 1,
64	63		2021, is governed by the law as it existed immediately before the
65	64		effective date of this Act, and that law is continued in effect for
66	65		that purpose.
67	66		SECTION 6. This Act takes effect January 1, 2020.