H.B. No. 1030
relating to availability of preferred providers.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter A, Chapter 1301, Insurance Code, as
effective April 1, 2005, is amended by adding Sections 1301.0045
and 1301.0046 to read as follows:
Sec. 1301.0045. CONSTRUCTION OF CHAPTER. Except as
provided by Section 1301.0046, this chapter may not be construed to
limit the level of reimbursement or the level of coverage,
including deductibles, copayments, coinsurance, or other
cost-sharing provisions, that are applicable to preferred
providers or nonpreferred providers.
Sec. 1301.0046. COINSURANCE REQUIREMENTS FOR SERVICES OF
NONPREFERRED PROVIDERS. The insured's coinsurance applicable to
payment to nonpreferred providers may not exceed 50 percent of the
total covered amount applicable to the medical or health care
SECTION 2. Section 1301.007, Insurance Code, as effective
April 1, 2005, is amended to read as follows:
Sec. 1301.007. RULES. The commissioner shall adopt rules
as necessary to:
(1) implement this chapter; and
(2) ensure reasonable accessibility and availability
of preferred provider services [
benefits and basic level benefits]
to residents of this state.
SECTION 3. This Act applies only to an insurance policy,
certificate, or contract delivered, issued for delivery, or renewed
on or after January 1, 2006. A policy, certificate, or contract
delivered, issued for delivery, or renewed before January 1, 2006,
is governed by the law as it existed immediately before the
effective date of this Act, and that law is continued in effect for
SECTION 4. This Act takes effect September 1, 2005.
President of the Senate Speaker of the House
I certify that H.B. No. 1030 was passed by the House on May
13, 2005, by a non-record vote.
Chief Clerk of the House
I certify that H.B. No. 1030 was passed by the Senate on May
25, 2005, by the following vote: Yeas 31, Nays 0.
Secretary of the Senate