81R9616 AJA-D
 
  By: Smithee H.B. No. 2576
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to direct payment by a health or automobile insurer of
  physicians and health care providers.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  The heading of Subchapter B, Chapter 1204,
  Insurance Code, is amended to read as follows:
  SUBCHAPTER B. ASSIGNMENT OF BENEFIT PAYMENTS; DIRECT PAYMENT OF
  BENEFITS
         SECTION 2.  Subchapter B, Chapter 1204, Insurance Code, is
  amended by adding Sections 1204.056, 1204.057, and 1204.058 to read
  as follows:
         Sec. 1204.056.  ASSIGNMENT OF BENEFITS OPTION REQUIRED.
  (a)  A health insurance policy claim form must provide an option
  for the claimant to assign benefits to a physician or health care
  provider who provided covered services.  For purposes of this
  subchapter, "health care provider" includes a licensed provider of
  ambulance services.
         (b)  The health insurer may require a written attestation of
  assignment of benefits.
         Sec. 1204.057.  AMOUNT OF PAYMENT UNDER ASSIGNMENT OF
  BENEFITS. A payment to a physician or health care provider under an
  assignment of benefits may not be more than the amount the insurer
  would have paid in the absence of an assignment of benefits.
         Sec. 1204.058.  DIRECT PAYMENT PROVISION AUTHORIZED. A
  health insurance policy may provide for payment of benefits
  directly to a physician or health care provider who provides
  covered services to a covered person, even in the absence of an
  assignment of benefits.
         SECTION 3.  Subchapter B, Chapter 1301, Insurance Code, is
  amended by adding Section 1301.0561 to read as follows:
         Sec. 1301.0561.  DIRECT PAYMENT OF PREFERRED PROVIDERS
  REQUIRED. An insurer that issues a preferred provider benefit plan
  shall pay a preferred provider directly for covered services
  provided to a person insured under the plan, in accordance with this
  chapter, without requiring an assignment of benefits.
         SECTION 4.  Subtitle C, Title 10, Insurance Code, is amended
  by adding Chapter 1955 to read as follows:
  CHAPTER 1955. PAYMENT OF CERTAIN BENEFITS UNDER AUTOMOBILE
  INSURANCE POLICY
         Sec. 1955.001.  APPLICABILITY OF CHAPTER. This chapter
  applies to an insurer writing automobile insurance in this state,
  including an insurance company, corporation, reciprocal or
  interinsurance exchange, mutual insurance company, association,
  Lloyd's plan, or other insurer.
         Sec. 1955.002.  ASSIGNMENT OF BENEFITS OPTION REQUIRED. An
  automobile insurance policy claim form must provide an option for
  the claimant to assign benefits to an ambulance service provider
  who provides services covered under the policy in connection with
  an occurrence covered by the policy. The automobile insurer may
  require a written attestation of assignment of benefits.
         Sec. 1955.003.  DIRECT PAYMENT PROVISION AUTHORIZED. An
  automobile insurance policy may provide for payment of benefits
  directly to an ambulance service provider who provides services
  covered under the policy in connection with an occurrence covered
  by the policy, even in the absence of an assignment of benefits.
         SECTION 5.  The changes in law made by this Act apply only to
  an insurance policy delivered, issued for delivery, or renewed on
  or after January 1, 2010. An insurance policy delivered, issued for
  delivery, or renewed before January 1, 2010, is governed by the law
  in effect immediately before the effective date of this Act, and
  that law is continued in effect for that purpose.
         SECTION 6.  This Act takes effect September 1, 2009.