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A BILL TO BE ENTITLED
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AN ACT
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relating to reimbursement under preferred provider benefit plans |
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for services provided by licensed podiatrists. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1301.062, Insurance Code, is amended to |
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read as follows: |
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Sec. 1301.062. PREFERRED PROVIDER CONTRACTS BETWEEN |
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INSURERS AND PODIATRISTS. A preferred provider contract between an |
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insurer and a podiatrist licensed by the Texas State Board of |
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Podiatric Medical Examiners must provide that: |
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(1) the podiatrist may request a copy of the coding |
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guidelines and payment schedules applicable to the compensation |
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that the podiatrist will receive under the contract for services; |
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(2) the insurer shall provide a copy of the coding |
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guidelines and payment schedules not later than the 30th day after |
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the date of the podiatrist's request; |
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(3) the insurer may not unilaterally make material |
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retroactive revisions to the coding guidelines and payment |
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schedules; [and] |
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(4) the podiatrist may, practicing within the scope of |
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the law regulating podiatry, furnish x-rays and nonprefabricated |
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orthotics covered by the health insurance policy; and |
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(5) the methodology used to compute the amount of |
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payment or reimbursement for services or procedures covered by the |
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contract is the same as the methodology used to compute the amount |
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of payment or reimbursement when the services or procedures are |
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provided by a physician, including an osteopathic physician. |
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SECTION 2. The change in law made by this Act applies only |
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to a preferred provider contract entered into or renewed on or after |
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January 1, 2016. A contract entered into or renewed before January |
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1, 2016, is governed by the law applicable to the contract |
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immediately before the effective date of this Act, and that law is |
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continued in effect for that purpose. |
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SECTION 3. This Act takes effect September 1, 2015. |