Amend the Davis amendment on p. 151 to read as follows:                      
	Amend CSHB 4 by adding the following appropriately numbered 
ARTICLES and renumbering existing ARTICLES and SECTIONS of the bill 
appropriately:

ARTICLE ___.  PROMPT PAYMENT OF PHYSICIANS AND HEALTH CARE 
PROVIDERS
	SECTION ___.01.  Sections 3A(c) and (e), Article 3.70-3C, 
Insurance Code, as added by Chapter 1024, Acts of the 75th 
Legislature, Regular Session, 1997, are amended to read as follows:
	(c)  Not later than the 30th [45th] day after the date that 
the insurer receives a clean claim from a preferred provider, the 
insurer shall:
		(1)  pay the total amount of the claim in accordance 
with the contract between the preferred provider and the insurer;
		(2)  pay the portion of the claim that is not in dispute 
and notify the preferred provider in writing why the remaining 
portion of the claim will not be paid; or
		(3)  notify the preferred provider in writing why the 
claim will not be paid.
	(e)  If the insurer acknowledges coverage of an insured under 
the health insurance policy but intends to audit the preferred 
provider claim, the insurer shall pay the charges submitted at 85 
percent of the contracted rate on the claim not later than the 30th
[45th] day after the date that the insurer receives the claim from 
the preferred provider. Following completion of the audit, any 
additional payment due a preferred provider or any refund due the 
insurer shall be made not later than the 30th day after the later of 
the date that:
		(1)  the preferred provider receives notice of the 
audit results; or        
		(2)  any appeal rights of the insured are exhausted.                          
	SECTION ___.02.  Sections 843.338, 843.340, and 843.346, 
Insurance Code, as effective June 1, 2003, are amended to read as 
follows:
	Sec. 843.338.  DEADLINE FOR ACTION ON CLEAN CLAIMS.  Not 
later than the 30th [45th] day after the date on which a health 
maintenance organization receives a clean claim from a physician or 
provider, the health maintenance organization shall:
		(1)  pay the total amount of the claim in accordance 
with the contract between the physician or provider and the health 
maintenance organization;
		(2)  pay the portion of the claim that is not in dispute 
and notify the physician or provider in writing why the remaining 
portion of the claim will not be paid; or
		(3)  notify the physician or provider in writing why 
the claim will not be paid.
	Sec. 843.340.  AUDITED CLAIMS.  A health maintenance 
organization that acknowledges coverage of an enrollee under a 
health care plan but intends to audit a claim submitted by a 
physician or provider shall pay the charges submitted at 85 percent 
of the contracted rate on the claim not later than the 30th [45th] 
day after the date on which the health maintenance organization 
receives the claim from a physician or provider. Following 
completion of the audit, any additional payment due a physician or 
provider or any refund due the health maintenance organization 
shall be made not later than the 30th day after the later of the date 
that:
		(1)  the physician or provider receives notice of the 
audit results; or     
		(2)  any appeal rights of the enrollee are exhausted.                         
	Sec. 843.346.  PAYMENT OF CLAIMS. Subject to Sections 
843.336-843.345, a health maintenance organization shall pay a 
physician or provider for health care services and benefits 
provided to an enrollee under the evidence of coverage and to which 
the enrollee is entitled under the terms of the evidence of coverage 
not later than:
		(1)  the 30th [45th] day after the date on which a claim 
for payment is received with the documentation reasonably necessary 
to process the claim; or
		(2)  if applicable, within the number of calendar days 
specified by written agreement between the physician or provider 
and the health maintenance organization.
	SECTION ___.03.  This article applies only to a claim for 
payment made under a benefit plan or evidence of coverage 
delivered, issued for delivery, or renewed on or after September 1, 
2003.  A benefit plan or evidence of coverage delivered, issued for 
delivery, or renewed before September 1, 2003, is governed by the 
law in effect immediately before that date and that law is continued 
in effect for this purpose.