Texas 2023 - 88th Regular

Texas Senate Bill SB2502 Compare Versions

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1	1	By: Kolkhorst S.B. No. 2502
2	2
3	3
4	4	A BILL TO BE ENTITLED
5	5	AN ACT
6	6	relating to certain limitations on reimbursements paid for
7	7	inpatient and outpatient hospital services for certain publicly
8	8	funded health benefit plan coverage for employees and retirees.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 1551.205, Insurance Code, is amended to
11	11	read as follows:
12	12	Sec. 1551.205. MAXIMUM RATES FOR FACILITIES; LIMITATIONS.
13	13	(a) Disregarding any contradictory contract terms or any other law
14	14	to the contrary, any facility, as such term is defined by Section
15	15	324.001 of the Health and Safety Code, that bills the group
16	16	benefits program, its administering firm, carrier, or their
17	17	designee, for health care services provided to an enrolled employee
18	18	or dependent will never be entitled to a rate for such health care
19	19	services thats exceed the rate established in the applicable rider
20	20	in the General Appropriations Act, Article I, Employees Retirement
21	21	System of Texas.
22	22	(b) A facility shall not discriminate against an employee
23	23	or dependent, or against the program, by refusing, to participate
24	24	in an administering firm's or health coverage plan's network, or by
25	25	refusing to serve an employee or dependent, or by providing health
26	26	care services of a lower standard and quality to an employee or
27	27	dependent than what the facility provides to other similar
28	28	patients, because of the maximum rating schedule imposed by
29	29	subsection (a) of this section.
30	30	(c) The board of trustees may not contract for or provide a
31	31	coverage plan that:
32	32	(1) excludes or limits coverage or services for
33	33	acquired immune deficiency syndrome, as defined by the Centers for
34	34	Disease Control and Prevention of the United States Public Health
35	35	Service, or human immunodeficiency virus infection;
36	36	(2) provides coverage for serious mental illness that
37	37	is less extensive than the coverage provided for any physical
38	38	illness; or
39	39	(3) may provide coverage for prescription drugs to
40	40	assist in stopping smoking at a lower benefit level than is provided
41	41	for other prescription drugs.
42	42	SECTION 2: Section 1575.104, Insurance Code, is amended to read as
43	43	follows:
44	44	Sec. 1575.104. TERMS OF CONTRACT; MAXIMUM RATES FOR
45	45	FACILITIES. (a) A contract for group coverage awarded by the
46	46	trustee must meet the minimum benefit and financial standards
47	47	adopted by the trustee.
48	48	(b) Disregarding any contradictory contract terms or any
49	49	other law to the contrary, any facility, as such term is defined by
50	50	Section 324.001 of the Health and Safety Code, that bills the group
51	51	program, its administrator, carrier, or their designee, for health
52	52	care services provided to an enrolled retiree or dependent will
53	53	never be entitled to a rate for such health care services that
54	54	exceeds the rate established in the applicable rider in the General
55	55	Appropriations Act, Article III, Teacher Retirement System.
56	56	(c) A facility shall not discriminate against a retiree or
57	57	dependent, or against the group program, by refusing to
58	58	participate in a group program administrator's or carrier's
59	59	network, or by refusing to serve a retiree or dependent, or by
60	60	providing health care services of a lower standard and quality to a
61	61	retiree or dependent than what the facility provides to other
62	62	similar patients, because of the maximum rating schedule imposed
63	63	by subsection (b) of this section.
64	64	SECTION 3. Subchapter B, Chapter 1579, Insurance Code, is
65	65	amended by adding Section 1579.0511, Insurance Code, to read as
66	66	follows:
67	67	Sec. 1579.0511. MAXIMUM RATES FOR FACILITIES. (a)
68	68	Disregarding any contradictory contract terms or any other law to
69	69	the contrary, any facility, as such term is defined by Section
70	70	324.001 of the Health and Safety Code, that bills the program, its
71	71	administering firm, health coverage plan, or their designee, for
72	72	health care services provided to an enrolled employee or dependent
73	73	will never be entitled to a rate for such health care services that
74	74	exceeds the rate established in the applicable rider in the General
75	75	Appropriations Act, Article III, Teacher Retirement System.
76	76	(b) A facility shall not discriminate against an employee
77	77	or dependent, or against the program, by refusing to participate in
78	78	an administering firm's or health coverage plan's network, or by
79	79	refusing to serve an employee or dependent, or by providing health
80	80	care services of a lower standard and quality to an employee or
81	81	dependent than what the facility provides to other similar
82	82	patients, because of the maximum rating schedule imposed by
83	83	subsection (a) of this section.
84	84	SECTION 4. Subchapter B of Chapter 1601, Insurance Code, is
85	85	amended by adding Section 1601.0581, Insurance Code, to read as
86	86	follows:
87	87	Sec. 1601.0581. MAXIMUM RATES FOR FACILITIES. (a)
88	88	Disregarding any contradictory contract terms or any other law to
89	89	the contrary, any facility, as such term is defined by Section
90	90	324.001 of the Health and Safety Code, that bills the uniform
91	91	program, its administering carrier, or their designee, for health
92	92	care services provided to an enrolled employee, retiree, or
93	93	dependent will never be entitled to a rate for such health care
94	94	services that exceeds the rate established in the applicable rider
95	95	in the General Appropriations Act, Article III, University of
96	96	Texas System and Texas A&M University System.
97	97	(b) A facility shall not discriminate against an employee,
98	98	retiree, or dependent, or against the uniform program, by refusing
99	99	to participate in an administering carrier's network, or by
100	100	refusing to serve an employee, retiree, or dependent, or by
101	101	providing health care services of a lower standard and quality to an
102	102	employee, retiree, or dependent than what the facility provides to
103	103	other similar patients, because of the maximum rating schedule
104	104	imposed by subsection (a) of this section.
105	105	SECTION 4. The maximum rating schedules imposed by Section
106	106	1551.202, Insurance Code, Section 1575.104, Insurance Code, as
107	107	amended by this Act, Section 1579.0511, Insurance Code, and Section
108	108	1601.0581, Insurance Code, as added by this Act, shall apply to any
109	109	bill for health care services provided by a facility with dates of
110	110	service beginning on or after September 1, 2024.
111	111	SECTION 5. This Act takes effect on September 1, 2023.