77R12328 AJA-F
By Bailey H.B. No. 1347
Substitute the following for H.B. No. 1347:
By Thompson C.S.H.B. No. 1347
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the regulation of certain health benefit plans.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Section 3(n), Article 3.70-3C, Insurance Code, as
1-5 added by Chapter 1024, Acts of the 75th Legislature, Regular
1-6 Session, 1997, is amended to read as follows:
1-7 (n) A preferred provider contract between an insurer and a
1-8 podiatrist licensed by the Texas State Board of Podiatric Medical
1-9 Examiners must provide that:
1-10 (1) the podiatrist may request, and the insurer shall
1-11 provide not later than the 30th day after the date of the request,
1-12 a copy of the coding guidelines and payment schedules applicable to
1-13 the compensation that the podiatrist will receive under the
1-14 contract for services;
1-15 (2) the insurer may not unilaterally make material
1-16 retroactive revisions to the coding guidelines and payment
1-17 schedules; and
1-18 (3) the podiatrist may, practicing within the scope of
1-19 the law regulating podiatry, furnish x-rays, physical modalities,
1-20 durable medical equipment, and nonprefabricated orthotics covered
1-21 by the health insurance policy.
1-22 SECTION 2. Section 18A(j), Texas Health Maintenance
1-23 Organization Act (Chapter 20A, Vernon's Texas Insurance Code), as
1-24 added by Chapter 1026, Acts of the 75th Legislature, Regular
2-1 Session, 1997, is amended to read as follows:
2-2 (j) A contract between a health maintenance organization and
2-3 a podiatrist licensed by the Texas State Board of Podiatric Medical
2-4 Examiners must provide that:
2-5 (1) the podiatrist may request, and the insurer shall
2-6 provide not later than the 30th day after the date of the request,
2-7 a copy of the coding guidelines and payment schedules applicable to
2-8 the compensation that the podiatrist will receive under the
2-9 contract for services;
2-10 (2) the insurer may not unilaterally make material
2-11 retroactive revisions to the coding guidelines and payment
2-12 schedules; and
2-13 (3) the podiatrist may, practicing within the scope of
2-14 the law regulating podiatry, furnish x-rays, physical modalities,
2-15 durable medical equipment, and nonprefabricated orthotics covered
2-16 by the evidence of coverage.
2-17 SECTION 3. (a) The change in law made by Section 3(n),
2-18 Article 3.70-3C, Insurance Code, as added by Chapter 1024, Acts of
2-19 the 75th Legislature, Regular Session, 1997, and amended by this
2-20 Act, applies only to a preferred provider contract entered into on
2-21 or after the effective date of this Act. A preferred provider
2-22 contract entered into before the effective date of this Act is
2-23 governed by the law as it existed immediately before the effective
2-24 date of this Act, and that law is continued in effect for that
2-25 purpose.
2-26 (b) The change in law made by Section 18A(j), Texas Health
2-27 Maintenance Organization Act (Chapter 20A, Vernon's Texas Insurance
3-1 Code), as added by Chapter 1026, Acts of the 75th Legislature,
3-2 Regular Session, 1997, and amended by this Act, applies only to a
3-3 contract between a health maintenance organization and a podiatrist
3-4 entered into on or after the effective date of this Act. A
3-5 contract between a health maintenance organization and a podiatrist
3-6 entered into before the effective date of this Act is governed by
3-7 the law as it existed immediately before the effective date of this
3-8 Act, and that law is continued in effect for that purpose.
3-9 SECTION 4. This Act takes effect September 1, 2001.