Bill Text: TX HB3152 | 2013-2014 | 83rd Legislature | Enrolled
Bill Title: Relating to the payment of and contracts with health care providers by certain entities under contract with a certified workers' compensation network.
Spectrum: Bipartisan Bill
Status: (Passed) 2013-06-14 - Effective on 9/1/13 [HB3152 Detail]
Download: Texas-2013-HB3152-Enrolled.html
H.B. No. 3152 |
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relating to the payment of and contracts with health care providers | ||
by certain entities under contract with a certified workers' | ||
compensation network. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 1305.153, Insurance Code, is amended by | ||
adding Subsections (f), (g), (h), (i), and (j) to read as follows: | ||
(f) If, for the purposes of credentialing and contracting | ||
with health care providers on behalf of the certified network, a | ||
person is serving as both a management contractor under Section | ||
1305.102 or a third party to which the network delegates a function | ||
and as an agent of the health care provider, the contract between | ||
the management contractor or third party and the health care | ||
provider must specify: | ||
(1) the certified network's contract rate for health | ||
care services; and | ||
(2) the amount of reimbursement the health care | ||
provider will be paid after the health care provider agent's fee for | ||
providing administrative services is applied. | ||
(g) If a management contractor or third party to which the | ||
network delegates a function is serving as an agent for health care | ||
providers in the certified network, the management contractor or | ||
third party must disclose that relationship in its contract with | ||
the certified network. | ||
(h) A contract described by Subsection (f), or a contract | ||
between a management contractor or third party to which the network | ||
delegates a function and a certified network, must comply with the | ||
requirements of this chapter. | ||
(i) If a contract described by Subsection (f) complies with | ||
the requirements of this chapter, the health care provider shall be | ||
reimbursed in accordance with the terms of the contract. If a | ||
contract described by Subsection (f) does not comply with the | ||
requirements of this chapter, the health care provider shall be | ||
reimbursed in accordance with the certified network's contracted | ||
rate. | ||
(j) A certified network, management contractor, or third | ||
party to which the network delegates a function may not require a | ||
health care provider, as a condition for contracting with the | ||
certified network, to utilize as a health care provider agent the | ||
management contractor or the third party. | ||
SECTION 2. With respect to a contract between a health care | ||
provider and a network, management contractor, or third party to | ||
which the network delegates a function, the change in law made by | ||
this Act applies only to a contract entered into or renewed on or | ||
after the effective date of this Act. A contract entered into or | ||
renewed before the effective date of this Act is governed by the law | ||
in effect immediately before the effective date of this Act, and | ||
that law is continued in effect for that purpose. | ||
SECTION 3. With respect to a contract between a certified | ||
network and a management contractor or third party to which the | ||
network delegates a function, the change in law made by this Act | ||
applies to a contract that is in effect on the effective date of | ||
this Act or entered into on or after that date. | ||
SECTION 4. This Act takes effect September 1, 2013. | ||
______________________________ | ______________________________ | |
President of the Senate | Speaker of the House | |
I certify that H.B. No. 3152 was passed by the House on May 7, | ||
2013, by the following vote: Yeas 143, Nays 0, 2 present, not | ||
voting. | ||
______________________________ | ||
Chief Clerk of the House | ||
I certify that H.B. No. 3152 was passed by the Senate on May | ||
17, 2013, by the following vote: Yeas 30, Nays 0. | ||
______________________________ | ||
Secretary of the Senate | ||
APPROVED: _____________________ | ||
Date | ||
_____________________ | ||
Governor |