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Amend HB 2064 (Senate committee report) as follows:
(1) Add the following appropriately numbered SECTIONS to
the bill and renumber subsequent SECTIONS of the bill accordingly:
SECTION ____. Section 843.342, Insurance Code, is amended
by adding Subsections (m) and (n) to read as follows:
(m) Notwithstanding any other provision of this section,
this subsection governs the payment of a penalty under this
section. For a penalty under this section relating to a clean claim
submitted by a physician or provider other than an institutional
provider, the health maintenance organization shall pay the entire
penalty to the physician or provider, except for any interest
computed under Subsection (c), which shall be paid to the Texas
Health Insurance Risk Pool. For a penalty under this section
relating to a clean claim submitted by an institutional provider,
the health maintenance organization shall pay 50 percent of the
total penalty amount computed under this section, including
interest, to the institutional provider and the remaining 50
percent of that amount to the Texas Health Insurance Risk Pool.
(n) In this section, "institutional provider" means a
hospital or other medical or health-related service facility that
provides care for the sick or injured or other care that may be
covered in an evidence of coverage.
SECTION ____. Section 1301.137, Insurance Code, is amended
by adding Subsection (l) to read as follows:
(l) Notwithstanding any other provision of this section,
this subsection governs the payment of a penalty under this
section. For a penalty under this section relating to a clean claim
submitted by a preferred provider other than an institutional
provider, the insurer shall pay the entire penalty to the preferred
provider, except for any interest computed under Subsection (c),
which shall be paid to the Texas Health Insurance Risk Pool. For a
penalty under this section relating to a clean claim submitted by an
institutional provider, the insurer shall pay 50 percent of the
penalty amount computed under this section, including interest, to
the institutional provider and the remaining 50 percent of that
amount to the Texas Health Insurance Risk Pool.
(2) In the recital to SECTION 1 of the bill (page 1, line
13), strike "adding Subsections (e-1) and (e-2)" and substitute
"adding Subsection (e-1)".
(3) In SECTION 1 of the bill, in amended Section
1506.105(e-1), Insurance Code (page 1, line 23), strike "Subsection
(e-2)" and substitute "the availability of funds under Section
1506.260".
(4) In SECTION 1 of the bill (page 1, lines 38-44), strike
added Section 1506.105(e-2), Insurance Code.
(5) In SECTION 2 of the bill (page 1, line 47, through page
2, line 3), strike added Section 1506.260, Insurance Code, and
substitute the following new Section 1506.260, Insurance Code:
Sec. 1506.260. FUNDING FOR PREMIUM DISCOUNTS. The board
shall collect penalty payments and interest paid by health
maintenance organizations as provided by Section 843.342 and
insurers as provided by Section 1301.137. The board may use funds
collected under this section only to finance premium discounts
under Section 1506.105(e-1). The board may require a health
maintenance organization or an insurer to make payments under this
section and make reports concerning those payments in a manner
determined by the board.
(6) In SECTION 3 of the bill (page 2, line 4), insert the
following between "3." and "(a)":
(a) Sections 843.342 and 1301.137, Insurance Code, as
amended by this Act, apply only to a penalty or interest on a
penalty owed with respect to a clean claim paid on or after the
effective date of this Act. A penalty or interest on a penalty owed
with respect to a clean claim paid before the effective date of this
Act is governed by the law in effect immediately before that date,
and that law is continued in effect for that purpose.
(7) In SECTION 3(a) of the bill (page 2, lines 7 and 8),
strike "2010" each place it appears and substitute "2011".
(8) In SECTION 3 of the bill, strike existing Subsection (b)
(page 2, lines 11-14).
(9) In SECTION 3 of the bill, reletter subsections
appropriately.