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AN ACT
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relating to mediation of the settlement of certain out-of-network |
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health benefit claims involving balance billing for members of the |
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Teacher Retirement System of Texas. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Sections 1467.001(1) and (3), Insurance Code, |
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are amended to read as follows: |
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(1) "Administrator" means: |
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(A) an administering firm for a health benefit |
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plan providing coverage under Chapter 1551, 1575, or 1579; and |
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(B) if applicable, the claims administrator for |
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the health benefit plan. |
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(3) "Enrollee" means an individual who is eligible to |
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receive benefits through a preferred provider benefit plan or a |
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health benefit plan under Chapter 1551, 1575, or 1579. |
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SECTION 2. Section 1467.002, Insurance Code, is amended to |
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read as follows: |
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Sec. 1467.002. APPLICABILITY OF CHAPTER. This chapter |
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applies to: |
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(1) a preferred provider benefit plan offered by an |
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insurer under Chapter 1301; and |
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(2) an administrator of a health benefit plan, other |
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than a health maintenance organization plan, under Chapter 1551, |
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1575, or 1579. |
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SECTION 3. The changes in law made by this Act apply only to |
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a health benefit claim for a medical service or supply provided on |
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or after January 1, 2018. A claim for a medical service or supply |
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provided before January 1, 2018, is governed by the law as it |
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existed immediately before the effective date of this Act, and that |
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law is continued in effect for that purpose. |
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SECTION 4. This Act takes effect September 1, 2017. |
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______________________________ |
______________________________ |
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President of the Senate |
Speaker of the House |
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I certify that H.B. No. 1428 was passed by the House on April |
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26, 2017, by the following vote: Yeas 147, Nays 0, 1 present, not |
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voting. |
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______________________________ |
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Chief Clerk of the House |
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I certify that H.B. No. 1428 was passed by the Senate on May |
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12, 2017, by the following vote: Yeas 31, Nays 0. |
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______________________________ |
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Secretary of the Senate |
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APPROVED: _____________________ |
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Date |
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_____________________ |
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Governor |