By: Madla S.B. No. 440 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. Subsection (n), Section 3, Article 3.70-3C, 1-5 Insurance Code, as added by Chapter 1024, Acts of the 75th 1-6 Legislature, Regular 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. Subsection (j), Section 18A, Texas Health 1-23 Maintenance Organization Act (Chapter 20A, Vernon's Texas Insurance 1-24 Code), as added by Chapter 1026, Acts of the 75th Legislature, 1-25 Regular Session, 1997, is amended to read as follows: 2-1 (j) A contract between a health maintenance organization and 2-2 a podiatrist licensed by the Texas State Board of Podiatric Medical 2-3 Examiners must provide that: 2-4 (1) the podiatrist may request, and the insurer shall 2-5 provide not later than the 30th day after the date of the request, 2-6 a copy of the coding guidelines and payment schedules applicable to 2-7 the compensation that the podiatrist will receive under the 2-8 contract for services; 2-9 (2) the insurer may not unilaterally make material 2-10 retroactive revisions to the coding guidelines and payment 2-11 schedules; and 2-12 (3) the podiatrist may, practicing within the scope of 2-13 the law regulating podiatry, furnish x-rays, physical modalities, 2-14 durable medical equipment, and nonprefabricated orthotics covered 2-15 by the evidence of coverage. 2-16 SECTION 3. (a) The change in law made by Subsection (n), 2-17 Section 3, Article 3.70-3C, Insurance Code, as added by Chapter 2-18 1024, Acts of the 75th Legislature, Regular Session, 1997, and 2-19 amended by this Act, applies only to a preferred provider contract 2-20 entered into on or after the effective date of this Act. A 2-21 preferred provider contract entered into before the effective date 2-22 of this Act is governed by the law as it existed immediately before 2-23 the effective date of this Act, and that law is continued in effect 2-24 for that purpose. 2-25 (b) The change in law made by Subsection (j), Section 18A, 2-26 Texas Health Maintenance Organization Act (Chapter 20A, Vernon's 3-1 Texas Insurance Code), as added by Chapter 1026, Acts of the 75th 3-2 Legislature, Regular Session, 1997, and amended by this Act, 3-3 applies only to a contract between a health maintenance 3-4 organization and a podiatrist entered into on or after the 3-5 effective date of this Act. A contract between a health 3-6 maintenance organization and a podiatrist entered into before the 3-7 effective date of this Act is governed by the law as it existed 3-8 immediately before the effective date of this Act, and that law is 3-9 continued in effect for that purpose. 3-10 SECTION 4. This Act takes effect September 1, 2001.