Bill Text: TX SB1795 | 2019-2020 | 86th Legislature | Introduced
Bill Title: Relating to notice by certain managed care entities of changes to reimbursement amounts applicable to certain physicians and health care providers.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2019-03-18 - Referred to Business & Commerce [SB1795 Detail]
Download: Texas-2019-SB1795-Introduced.html
86R11459 JES-D | ||
By: Zaffirini | S.B. No. 1795 |
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relating to notice by certain managed care entities of changes to | ||
reimbursement amounts applicable to certain physicians and health | ||
care providers. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. The heading to Chapter 1453, Insurance Code, is | ||
amended to read as follows: | ||
CHAPTER 1453. DISCLOSURE OF REIMBURSEMENT GUIDELINES AND AMOUNTS | ||
UNDER MANAGED CARE PLAN | ||
SECTION 2. Section 1453.001, Insurance Code, is amended by | ||
adding Subdivision (4) to read as follows: | ||
(4) "Physician" means an individual licensed to | ||
practice medicine in this or another state. | ||
SECTION 3. Chapter 1453, Insurance Code, is amended by | ||
adding Section 1453.004 to read as follows: | ||
Sec. 1453.004. NOTICE OF CHANGE TO REIMBURSEMENT AMOUNT. | ||
(a) A managed care entity shall provide to each physician and | ||
health care provider under contract with the managed care entity | ||
notice of any change to a reimbursement amount that will be paid to | ||
the physician or health care provider for a good or service provided | ||
by the physician or health care provider. The notice must be | ||
provided before the effective date of the change. | ||
(b) The notice required by this section must be sent: | ||
(1) directly to each physician or health care provider | ||
that may be affected by the reimbursement amount change; and | ||
(2) in a manner that is trackable and indicates the | ||
date and time the notice was sent, including: | ||
(A) by certified mail, return receipt requested, | ||
to the physician's or provider's address; or | ||
(B) by e-mail to an e-mail address specified by | ||
the physician or provider. | ||
SECTION 4. This Act takes effect September 1, 2019. |