Texas 2023 - 88th Regular

Texas House Bill HB4500 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New	Differences
1	1	H.B. No. 4500
2	2
3	3
4	4	AN ACT
5	5	relating to electronic verification of health benefits by health
6	6	benefit plan issuers for certain physicians and health care
7	7	providers.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Subtitle A, Title 8, Insurance Code, is amended
10	10	by adding Chapter 1223 to read as follows:
11	11	CHAPTER 1223. VERIFICATION OF HEALTH BENEFITS
12	12	Sec. 1223.001. APPLICABILITY OF CHAPTER. (a) This chapter
13	13	applies only to a health benefit plan that provides benefits for
14	14	medical or surgical expenses incurred as a result of a health
15	15	condition, accident, or sickness, including an individual, group,
16	16	blanket, or franchise insurance policy or insurance agreement, a
17	17	group hospital service contract, or an individual or group evidence
18	18	of coverage or similar coverage document that is issued by:
19	19	(1) an insurance company;
20	20	(2) a group hospital service corporation operating
21	21	under Chapter 842;
22	22	(3) a health maintenance organization operating under
23	23	Chapter 843;
24	24	(4) an approved nonprofit health corporation that
25	25	holds a certificate of authority under Chapter 844;
26	26	(5) a multiple employer welfare arrangement that holds
27	27	a certificate of authority under Chapter 846;
28	28	(6) a stipulated premium company operating under
29	29	Chapter 884;
30	30	(7) a Lloyd's plan operating under Chapter 941; or
31	31	(8) an exchange operating under Chapter 942.
32	32	(b) Notwithstanding any other law, this chapter applies to:
33	33	(1) a small employer health benefit plan subject to
34	34	Chapter 1501, including coverage provided through a health group
35	35	cooperative under Subchapter B of that chapter;
36	36	(2) a standard health benefit plan issued under
37	37	Chapter 1507;
38	38	(3) a basic coverage plan under Chapter 1551;
39	39	(4) a basic plan under Chapter 1575;
40	40	(5) a primary care coverage plan under Chapter 1579;
41	41	(6) a plan providing basic coverage under Chapter
42	42	1601;
43	43	(7) alternative health benefit coverage offered by a
44	44	subsidiary of the Texas Mutual Insurance Company under Subchapter
45	45	M, Chapter 2054;
46	46	(8) group health coverage made available by a school
47	47	district in accordance with Section 22.004, Education Code;
48	48	(9) a regional or local health care program operated
49	49	under Section 75.104, Health and Safety Code; and
50	50	(10) a self-funded health benefit plan sponsored by a
51	51	professional employer organization under Chapter 91, Labor Code.
52	52	(c) This chapter does not apply to the state Medicaid
53	53	program, including the Medicaid managed care program operated under
54	54	Chapter 533, Government Code, or the child health plan program
55	55	operated under Chapter 62, Health and Safety Code.
56	56	Sec. 1223.002. INTERNET WEBSITE FOR VERIFICATION REQUIRED
57	57	FOR EMERGENCY PHYSICIANS AND HEALTH CARE PROVIDERS. (a) A health
58	58	benefit plan issuer shall maintain and make available a secure
59	59	system on the issuer's Internet website that allows a physician or
60	60	health care provider for a hospital or freestanding emergency
61	61	medical care facility to determine at any time:
62	62	(1) whether the physician's or provider's patient is
63	63	covered by the issuer's health benefit plan; and
64	64	(2) the deductible, copayment, or coinsurance for
65	65	which the patient is responsible.
66	66	(b) A health benefit plan issuer may provide the information
67	67	described by Subsection (a) through:
68	68	(1) an existing Internet portal that is available at
69	69	all times; or
70	70	(2) an Internet portal that is:
71	71	(A) provided by a third party contracting with
72	72	the issuer; and
73	73	(B) available at all times.
74	74	SECTION 2. This Act takes effect January 1, 2024.
75	75	______________________________ ______________________________
76	76	President of the Senate Speaker of the House
77	77	I certify that H.B. No. 4500 was passed by the House on May 9,
78	78	2023, by the following vote: Yeas 140, Nays 2, 2 present, not
79	79	voting; and that the House concurred in Senate amendments to H.B.
80	80	No. 4500 on May 26, 2023, by the following vote: Yeas 137, Nays 1,
81	81	2 present, not voting.
82	82	______________________________
83	83	Chief Clerk of the House
84	84	I certify that H.B. No. 4500 was passed by the Senate, with
85	85	amendments, on May 24, 2023, by the following vote: Yeas 31, Nays
86	86	0.
87	87	______________________________
88	88	Secretary of the Senate
89	89	APPROVED: __________________
90	90	Date
91	91	__________________
92	92	Governor