By:  Cain                                             S.B. No. 1739
         Line and page numbers may not match official copy.
         Bill not drafted by TLC or Senate E&E.
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to the regulation of health benefit plans.
 1-3           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-4           SECTION 1.  Amend Section 3, Article 3.70-3C, Insurance code,
 1-5     by adding a new subsection (o) to read as follows:
 1-6           (o)  An insurer must verify coverage and benefits for an
 1-7     insured to a preferred provider who requests such information prior
 1-8     to rendering covered services.  Once verified, the insurer may not
 1-9     deny payment for the services rendered unless written notice of an
1-10     error in verification is received by the preferred provider before
1-11     the treatment is performed.
1-12           SECTION 2.  Amend Article 20A.18A, Insurance Code, by adding
1-13     a new subsection (k) to read as follows:
1-14           (k)  A health maintenance organization must verify coverage
1-15     and benefits for an enrollee to a physician or provider who
1-16     requests such information prior to rendering covered services.
1-17     Once verified, the health maintenance organization may not deny
1-18     payment for the services rendered unless written notice of an error
1-19     in verification is received by the physician or provider before the
1-20     treatment is performed.
1-21           SECTION 3.  This Act takes effect September 1, 2001.