By: Nelson S.B. No. 130 A BILL TO BE ENTITLED AN ACT 1-1 relating to certain unfair practices by insurers and certain 1-2 related entities regarding preferred providers of health care. 1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-4 SECTION 1. Article 3.70-3C, Insurance Code, as added by 1-5 Chapter 1024, Acts of the 75th Legislature, Regular Session, 1997, 1-6 is amended by adding Section 7A to read as follows: 1-7 Sec. 7A. RESTRICTIONS ON PAYMENT AND REIMBURSEMENT. 1-8 (a) Except as provided by Subsection (b) of this section, an 1-9 insurer or third party administrator may not reimburse a physician, 1-10 practitioner, hospital, institutional provider, or organization of 1-11 physicians and health care providers on a discounted fee basis for 1-12 covered services that are provided to an insured unless: 1-13 (1) the insurer or third party administrator has 1-14 contracted with the physician, practitioner, hospital, 1-15 institutional provider, or organization of physicians and health 1-16 care providers; 1-17 (2) the physician, practitioner, hospital, 1-18 institutional provider, or organization of physicians and health 1-19 care providers has agreed to the contract and has agreed to provide 1-20 health care services under the terms of the contract; and 1-21 (3) the insurer or third party administrator has 1-22 agreed to provide coverage for those health care services under the 1-23 health insurance policy. 1-24 (b) A party to a preferred provider contract may not sell, 2-1 lease, or otherwise transfer information regarding the payment or 2-2 reimbursement terms of the contract without the express authority 2-3 and prior adequate notification of the other contracting parties. 2-4 This subsection does not affect the commissioner's authority under 2-5 this code to request and obtain information. 2-6 (c) An insurer or third party administrator who violates 2-7 this section commits an unfair act or deceptive practice in 2-8 violation of Articles 21.21 and 21.21-2 of this code. 2-9 SECTION 2. The importance of this legislation and the 2-10 crowded condition of the calendars in both houses create an 2-11 emergency and an imperative public necessity that the 2-12 constitutional rule requiring bills to be read on three several 2-13 days in each house be suspended, and this rule is hereby suspended, 2-14 and that this Act take effect and be in force from and after its 2-15 passage, and it is so enacted.