| |
|
|
A BILL TO BE ENTITLED
|
|
|
AN ACT
|
|
|
relating to regulation of payment of healthcare providers. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. Subsection (a)(4), Section 843.321, Insurance |
|
|
Code, is amended to read as follows: |
|
|
(4) the contract may be terminated by the physician or |
|
|
provider on or before the 30th day after the date the physician or |
|
|
provider receives information requested under [this] subsection |
|
|
(3) without penalty or discrimination in participation in other |
|
|
health care products or plans. |
|
|
SECTION 2. Subsection (f), Section 843.348, Insurance Code, |
|
|
is amended to read as follows: |
|
|
(f) A health maintenance organization shall have |
|
|
appropriate personnel reasonably available at a toll-free |
|
|
telephone number to respond to requests for a preauthorization |
|
|
between 6 a.m. and 6 p.m. central time Monday through Friday on each |
|
|
day that is not a legal holiday [and between 9 a.m. and noon central
|
|
|
time on Saturday, Sunday, and legal holidays]. A health |
|
|
maintenance organization must have a telephone system capable of |
|
|
accepting or recording incoming phone calls for preauthorizations |
|
|
after 6 p.m. central time Monday through Friday and [after noon
|
|
|
central time] on Saturday, Sunday, and legal holidays and |
|
|
responding to each of those calls not later than [24 hours] the next |
|
|
business day after the call is received. |
|
|
SECTION 3. Subsection (e), Section 1301.135, Insurance |
|
|
Code, is amended to read as follows: |
|
|
(e) An insurer shall have appropriate personnel reasonably |
|
|
available at a toll-free telephone number to respond to requests |
|
|
for a preauthorization between 6 a.m. and 6 p.m. central time Monday |
|
|
through Friday on each day that is not a legal holiday and between 9 |
|
|
a.m. and noon central time on Saturday, Sunday, and legal holidays. |
|
|
An insurer must have a telephone system capable of accepting or |
|
|
recording incoming phone calls for preauthorizations after 6 p.m. |
|
|
central time Monday through Friday [and after noon central time on
|
|
|
Saturday, Sunday, and legal holidays] and responding to each of |
|
|
those calls not later than [24 hours] the next business day after |
|
|
the call is received. |
|
|
SECTION 4. Subsection (4), Section 1301.136(a), Insurance |
|
|
Code, is amended to read as follows: |
|
|
(4) the contract may be terminated by the preferred provider |
|
|
on or before the 30th day after the date the preferred provider |
|
|
receives information requested under [this] subsection (3) without |
|
|
penalty or discrimination in participation in other health care |
|
|
products or plans. |
|
|
SECTION 5. This Act takes effect September 1, 2007. |