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A BILL TO BE ENTITLED
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AN ACT
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relating to identification cards issued by health maintenance |
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organizations and preferred provider organizations. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 843.209, Insurance Code, is amended to |
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read as follows: |
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Sec. 843.209. IDENTIFICATION CARD. (a) An identification |
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card or other similar document issued by a health maintenance |
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organization to an enrollee must: |
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(1) indicate that the health maintenance organization |
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is regulated under this code and subject to the provisions of |
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Subchapter J; [and] |
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(2) display: |
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(A) the first date on which the enrollee became |
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enrolled; or |
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(B) a toll-free number a physician or provider |
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may use to obtain that date; and |
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(3) display the acronym "HMO" in the location of the |
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health maintenance organization's choice. |
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(b) An identification card or other similar document that |
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bears the acronym "HMO" as required by Subsection (a) indicates |
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that health benefit coverage for health care services provided by a |
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participating physician or provider does not ensure the enrollee |
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has access to: |
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(1) health care services at a discounted rate if the |
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services are provided by a physician or provider who is not included |
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in the health maintenance organization delivery network; or |
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(2) other fee discounts available under the health |
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maintenance organization delivery network. |
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SECTION 2. Section 1301.162, Insurance Code, is amended to |
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read as follows: |
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Sec. 1301.162. IDENTIFICATION CARD. (a) An identification |
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card or other similar document issued by an insurer regulated by |
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this code and subject to this chapter to an individual insured must: |
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(1) display: |
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(A) [(1)] the first date on which the individual |
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became insured under the plan; or |
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(B) [(2)] a toll-free number a physician or |
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health care provider may use to obtain that date; and |
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(2) display the acronym "PPO" in the location of the |
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insurer's choice. |
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(b) An identification card or other similar document that |
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bears the acronym "PPO" as required by Subsection (a) indicates |
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that health benefit coverage for medical care or health care |
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services provided by a preferred provider does not ensure the |
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insured has access to: |
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(1) medical care or health care services at a |
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discounted rate if the services are provided by an out-of-network |
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provider; or |
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(2) other fee discounts available under the provider |
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network. |
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SECTION 3. Sections 843.209 and 1301.162, Insurance Code, |
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as amended by this Act, apply only to an identification card or |
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other similar document issued on or after January 1, 2026. |
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SECTION 4. This Act takes effect September 1, 2025. |