BILL ANALYSIS

H.B. 1570

By: Thompson

Insurance

Committee Report (Unamended)

BACKGROUND AND PURPOSE

Provisions of the Insurance Code prohibit the discriminatory payment or reimbursement of providers based solely on the type of health care practitioner selected by the insured. However, several insurers who do business in Texas have issued preferred provider contracts to participating podiatrists which arbitrarily provide a lower level of reimbursement if the covered service is provided by a podiatrist rather than a physician. 

H.B. 1570 requires a preferred provider contract between an insurer and a podiatrist to provide that the methodology used to compute the amount of payment or reimbursement for services or procedures covered by the contract is the same as the methodology used to compute the amount of payment or reimbursement when the same services are provided by a physician.

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.

ANALYSIS

H.B. 1570 amends the Insurance Code to require that a preferred provider contract between an insurer and a podiatrist provide that the methodology used to compute the amount of payment or reimbursement for services or procedures covered by the contract is the same as the methodology used to compute the amount of payment or reimbursement when services or procedures are provided by a physician, in addition to other requirements.

H.B. 1570 defines "podiatrist" to mean a podiatrist licensed by the Texas State Board of Podiatric Medical Examiners, and makes its provisions applicable to a preferred provider contract entered into or renewed on or after January 1, 2010.

EFFECTIVE DATE

September 1, 2009.