| TO: | Honorable Robert Duncan, Chair, Senate Committee on State Affairs |
| FROM: | John S. O'Brien, Deputy Director, Legislative Budget Board |
| IN RE: | SB536 by Van de Putte (Relating to reimbursement under certain health benefit plans for services provided by licensed podiatrists.), As Introduced |
The bill would amend the Insurance Code relating to reimbursement under health benefit plans for services provided by licensed podiatrists. It is anticipated that the bill would result in additional complaints from podiatrists to the Texas Department of Insurance (TDI) alleging disparity in reimbursement rates. Podiatrists may find it difficult to document any disparity since physician and provider fee schedules are proprietary and by law cannot be released except for a legitimate business purpose by the releasing party.
TDI anticipates that enrollees will believe that they are not required to seek care only from a network provider which may result in either increases in premium rates for the additional coverage or balance billing of enrollees by non-contracted podiatrists whose claims are denied because they are out of network.
TDI anticipates that any additional workload resulting from the passage of the bill could be reasonably absorbed within current resources. The bill would take effect September 1, 2005.
| Source Agencies: | 454 Department of Insurance, 512 Board of Podiatric Medical Examiners
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| LBB Staff: | JOB, SR, MW, NV
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