Bill Text: TX HB2757 | 2015-2016 | 84th Legislature | Introduced

Texas House Bill 2757 (Prior Session Legislation)

Introduced

Bill Title: Relating to prompt payment of physicians and health care providers under contract with certain self-insured health benefit plans.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2015-03-16 - Referred to Insurance [HB2757 Detail]

Download: Texas-2015-HB2757-Introduced.html

	84R7545 AJA-D

	By: Bonnen of Galveston	H.B. No. 2757



	A BILL TO BE ENTITLED
	AN ACT
	relating to prompt payment of physicians and health care providers
	under contract with certain self-insured health benefit plans.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1. Subchapter C, Chapter 1301, Insurance Code, is
	amended by adding Section 1301.1091 to read as follows:
	Sec. 1301.1091. APPLICABILITY TO CERTAIN SELF-INSURED
	PLANS. (a) This section applies only with respect to a
	self-insured plan that:
	(1) provides medical or health care benefits to plan
	enrollees in the manner of a preferred provider benefit plan; and
	(2) is administered by an insurer acting as a
	third-party administrator.
	(b) The payment of a claim submitted to an insurer acting as
	a third-party administrator for a plan described by Subsection (a)
	by a physician or health care provider who is under contract to
	provide medical care or health care to plan enrollees is subject to
	this subchapter and Section 1301.137 as if the claim were made by a
	preferred provider under a preferred provider benefit plan issued
	by the insurer, except to the extent that the insurer asserts that
	the claim is not payable because the medical care or health care
	services for which the claim is made are not covered under the plan.
	SECTION 2. (a) The change in law made by this Act applies
	only to payment for services under:
	(1) a contract between an insurer and a self-insured
	plan sponsor entered into or renewed on or after January 1, 2016;
	and
	(2) a contract between a physician or health care
	provider and the insurer or plan sponsor entered into on or after
	that date in connection with the plan.
	(b) Payment for services under a contract between an insurer
	and a self-insured plan sponsor entered into or renewed before
	January 1, 2016, or a contract between a physician or health care
	provider and the insurer or plan sponsor entered into or renewed
	before that date is governed by the law as it existed immediately
	before the effective date of this Act, and that law is continued in
	effect for that purpose.
	SECTION 3. This Act takes effect September 1, 2015.