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A BILL TO BE ENTITLED
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AN ACT
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Relating to certain penalties paid to the Texas Health Insurance |
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Risk Pool. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 843.342(m), Insurance Code, is amended |
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to read as follows: |
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(m) Notwithstanding any other provision of this section, |
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this subsection governs the payment of a penalty under this |
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section. For a penalty under this section relating to a clean claim |
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submitted by a physician or provider other than an institutional |
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provider, the health maintenance organization shall pay the entire |
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penalty to the physician or provider, except for any interest |
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computed under Subsection (c), which shall be paid to the Texas |
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Health Insurance Risk Pool. [For a penalty under this section
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relating to a clean claim submitted by an institutional provider,
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the health maintenance organization shall pay 50 percent of the
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total penalty amount computed under this section, including
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interest, to the institutional provider and the remaining 50
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percent of that amount to the Texas Health Insurance Risk Pool.] |
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SECTION 2. Section 1301.137(l), Insurance Code, is amended |
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to read as follows: |
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(l) Notwithstanding any other provision of this section, |
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this subsection governs the payment of a penalty under this |
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section. For a penalty under this section relating to a clean claim |
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submitted by a preferred provider other than an institutional |
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provider, the insurer shall pay the entire penalty to the preferred |
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provider, except for any interest computed under Subsection (c), |
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which shall be paid to the Texas Health Insurance Risk Pool. [For a
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penalty under this section relating to a clean claim submitted by an
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institutional provider, the insurer shall pay 50 percent of the
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penalty amount computed under this section, including interest, to
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the institutional provider and the remaining 50 percent of that
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amount to the Texas Health Insurance Risk Pool.] |
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SECTION 3. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect on September 1, 2015. |
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SECTION 4. The importance of this legislation and the |
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crowded condition of the calendars in both houses create an |
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emergency and an imperative public necessity that the |
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constitutional rule requiring bills to be read on three separate |
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days in each house be suspended, and this rule hereby suspended, and |
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that this act take effect and be in force from and after its |
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passage, and it so enacted. |