1-1     By:  Madla                                             S.B. No. 440
 1-2           (In the Senate - Filed January 29, 2001; January 30, 2001,
 1-3     read first time and referred to Committee on Business and Commerce;
 1-4     April 17, 2001, reported adversely, with favorable Committee
 1-5     Substitute by the following vote:  Yeas 5, Nays 0; April 17, 2001,
 1-6     sent to printer.)
 1-7     COMMITTEE SUBSTITUTE FOR S.B. No. 440             By:  Van de Putte
 1-8                            A BILL TO BE ENTITLED
 1-9                                   AN ACT
1-10     relating to the regulation of certain health benefit plans.
1-11           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-12           SECTION 1.  Subsection (n), Section 3, Article 3.70-3C,
1-13     Insurance Code, as added by Chapter 1024, Acts of the 75th
1-14     Legislature, Regular Session, 1997, is amended to read as follows:
1-15           (n)  A preferred provider contract between an insurer and a
1-16     podiatrist licensed by the Texas State Board of Podiatric Medical
1-17     Examiners must provide that:
1-18                 (1)  the podiatrist may request, and the insurer shall
1-19     provide not later than the 30th day after the date of the request,
1-20     a copy of the coding guidelines and payment schedules applicable to
1-21     the compensation that the podiatrist will receive under the
1-22     contract for services;
1-23                 (2)  the insurer may not unilaterally make material
1-24     retroactive revisions to the coding guidelines and payment
1-25     schedules; and
1-26                 (3)  the podiatrist may, practicing within the scope of
1-27     the law regulating podiatry, furnish x-rays, physical modalities,
1-28     durable medical equipment, and nonprefabricated orthotics covered
1-29     by the health insurance policy.
1-30           SECTION 2.  Subsection (j), Section 18A, Texas Health
1-31     Maintenance Organization Act (Chapter 20A, Vernon's Texas Insurance
1-32     Code), as added by Chapter 1026, Acts of the 75th Legislature,
1-33     Regular Session, 1997, is amended to read as follows:
1-34           (j)  A contract between a health maintenance organization and
1-35     a podiatrist licensed by the Texas State Board of Podiatric Medical
1-36     Examiners must provide that:
1-37                 (1)  the podiatrist may request, and the insurer shall
1-38     provide not later than the 30th day after the date of the request,
1-39     a copy of the coding guidelines and payment schedules applicable to
1-40     the compensation that the podiatrist will receive under the
1-41     contract for services;
1-42                 (2)  the insurer may not unilaterally make material
1-43     retroactive revisions to the coding guidelines and payment
1-44     schedules; and
1-45                 (3)  the podiatrist may, practicing within the scope of
1-46     the law regulating podiatry, furnish x-rays, physical modalities,
1-47     durable medical equipment, and nonprefabricated orthotics covered
1-48     by the evidence of coverage.
1-49           SECTION 3.  (a)  The change in law made by Subsection (n),
1-50     Section 3, Article 3.70-3C, Insurance Code, as added by Chapter
1-51     1024, Acts of the 75th Legislature, Regular Session, 1997, and
1-52     amended by this Act, applies only to a preferred provider contract
1-53     entered into on or after the effective date of this Act.  A
1-54     preferred provider contract entered into before the effective date
1-55     of this Act is governed by the law as it existed immediately before
1-56     the effective date of this Act, and that law is continued in effect
1-57     for that purpose.
1-58           (b)  The change in law made by Subsection (j), Section 18A,
1-59     Texas Health Maintenance Organization Act (Chapter 20A, Vernon's
1-60     Texas Insurance Code), as added by Chapter 1026, Acts of the 75th
1-61     Legislature, Regular Session, 1997, and amended by this Act,
1-62     applies only to a contract between a health maintenance
1-63     organization and a podiatrist entered into on or after the
1-64     effective date of this Act.  A contract between a health
 2-1     maintenance organization and a podiatrist entered into before the
 2-2     effective date of this Act is governed by the law as it existed
 2-3     immediately before the effective date of this Act, and that law is
 2-4     continued in effect for that purpose.
 2-5           SECTION 4.  This Act takes effect September 1, 2001.
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