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.