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. 2-6 * * * * *