89R10939 DNC-F
By: Oliverson H.B. No. 3414
A BILL TO BE ENTITLED
AN ACT
relating to preferred provider benefit plan out-of-pocket expense
credits for payments made by an insured directly to a physician
providing direct primary care.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 1301.140, Insurance Code, is amended by
adding Subsection (a-1) to read as follows:
(a-1) For purposes of Subsection (a), an insurer who
provides coverage for primary care services shall treat a direct
fee charged by a physician who provides direct primary care as a fee
for a medically necessary covered medical or health care service or
supply. In this subsection, "direct fee" and "direct primary care"
have the meanings assigned by Section 162.251, Occupations Code.
SECTION 2. Section 1301.140(a-1), Insurance Code, as added
by this Act, applies only to a preferred provider benefit plan that
is delivered, issued for delivery, or renewed on or after January 1,
2026.
SECTION 3. This Act takes effect September 1, 2025.