| 1 | 1 | | 89R1826 RDS-D |
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| 2 | 2 | | By: Cortez H.B. No. 335 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | |
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| 6 | 6 | | |
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| 7 | 7 | | A BILL TO BE ENTITLED |
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| 8 | 8 | | AN ACT |
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| 9 | 9 | | relating to the payments and reimbursements for noncontracting and |
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| 10 | 10 | | contracting provider dentists under certain health benefit plans. |
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| 11 | 11 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 12 | 12 | | SECTION 1. Section 1451.206(a), Insurance Code, is amended |
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| 13 | 13 | | to read as follows: |
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| 14 | 14 | | (a) The employee benefit plan or health insurance policy |
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| 15 | 15 | | shall: |
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| 16 | 16 | | (1) provide: |
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| 17 | 17 | | (A) [that payment or reimbursement for a |
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| 18 | 18 | | noncontracting provider dentist shall be the same as payment or |
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| 19 | 19 | | reimbursement for a contracting provider dentist; |
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| 20 | 20 | | [(B)] that the party to or beneficiary of the |
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| 21 | 21 | | plan or policy may assign the right to payment or reimbursement to |
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| 22 | 22 | | the dentist who provides the dental care services; and |
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| 23 | 23 | | (B) [(C)] one or more methods of payment or |
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| 24 | 24 | | reimbursement that provide the dentist 100 percent of the |
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| 25 | 25 | | contracted amount of the payment or reimbursement and that do not |
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| 26 | 26 | | require the dentist to incur a fee to access the payment or |
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| 27 | 27 | | reimbursement; and |
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| 28 | 28 | | (2) disclose on the Internet website required under |
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| 29 | 29 | | Section 1451.205 and on request of a dentist or a party to or |
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| 30 | 30 | | beneficiary of the plan or policy the fees, if any, associated with |
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| 31 | 31 | | the methods of payment or reimbursement available under the plan or |
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| 32 | 32 | | policy. |
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| 33 | 33 | | SECTION 2. Section 1451.206, Insurance Code, as amended by |
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| 34 | 34 | | this Act, applies only to a health benefit plan delivered, issued |
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| 35 | 35 | | for delivery, or renewed on or after January 1, 2026. A plan |
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| 36 | 36 | | delivered, issued for delivery, or renewed before January 1, 2026, |
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| 37 | 37 | | is governed by the law as it existed immediately before the |
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| 38 | 38 | | effective date of this Act, and that law is continued in effect for |
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| 39 | 39 | | that purpose. |
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| 40 | 40 | | SECTION 3. This Act takes effect September 1, 2025. |
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