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A BILL TO BE ENTITLED
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AN ACT
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relating to the establishment of a pilot program for the electronic |
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transmission of certain subrogation claims. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subtitle A, Title 8, Insurance Code, is amended |
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by adding Chapter 1222 to read as follows: |
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CHAPTER 1222. MOTOR VEHICLE ACCIDENTS AND AUTOMOBILE INSURANCE |
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SUBROGATION PILOT PROGRAM |
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Sec. 1222.001. DEFINITIONS. In this chapter: |
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(1) "Automobile insurer" means an insurer writing |
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automobile insurance in this state, including an insurance company, |
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corporation, reciprocal or interinsurance exchange, mutual |
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insurance company, Lloyd's plan, county mutual insurance company, |
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or other insurer. |
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(2) "Enrollee" means an individual entitled to |
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benefits under a health benefit plan. |
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(3) "Health benefit plan issuer" means: |
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(A) a managed care organization issuing a managed |
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care plan offered under Chapter 533, Government Code; |
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(B) the Health and Human Services Commission or |
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another entity administering the state Medicaid program operated |
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under Chapter 32, Human Resources Code, or the state child health |
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plan or health benefits plan for children under Chapter 62 or 63, |
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Health and Safety Code; |
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(C) the Employees Retirement System of Texas or |
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another entity issuing or administering a basic coverage plan under |
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Chapter 1551; |
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(D) the Teacher Retirement System of Texas or |
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another entity issuing or administering a basic plan under Chapter |
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1575 or a primary care coverage plan under Chapter 1579; and |
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(E) The Texas A&M University System or The |
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University of Texas System or another entity issuing or |
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administering basic coverage under Chapter 1601. |
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(4) "Payor" means a health benefit plan issuer who: |
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(A) pays benefits to or on behalf of an enrollee |
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as a result of personal injuries to the enrollee caused by the |
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tortious conduct of a third party; and |
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(B) has a contractual or statutory right of |
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subrogation for the benefits paid. |
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Sec. 1222.002. PILOT PROGRAM. (a) The department shall |
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establish a pilot program to evaluate the benefits of using an |
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electronic records management system to collect and transmit |
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information related to injuries arising from motor vehicle |
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accidents to facilitate identification of potential subrogation |
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claims and collection of amounts owed. |
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(b) Subject to the availability of funds, the department |
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shall contract with an organization to operate the pilot program. |
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The department shall select the organization to serve as the |
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contractor using competitive bidding. |
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(c) A payor shall provide the contractor with the |
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information required by the contractor related to benefits paid for |
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injuries arising from motor vehicle accidents in this state. Each |
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automobile insurer shall provide the contractor with the |
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information required by the contractor related to motor vehicle |
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accidents in this state. The contractor shall use the information |
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provided under this subsection to determine if the payor has a right |
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of subrogation against an automobile insurer and, where |
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appropriate, seek recovery of the amounts owed on behalf of the |
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payor. |
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(d) The contractor shall report the results of the |
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subrogation determination and subrogation claim to the payor and |
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provide any funds recovered to the payor. |
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Sec. 1222.003. CONFIDENTIALITY. The contractor operating |
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the pilot program shall maintain the confidentiality of all |
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information provided to the contractor by a payor under this |
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chapter and may use the information only for the purposes of the |
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pilot program. |
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Sec. 1222.004. EVALUATION AND REPORT. Not later than |
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December 1, 2016, the department shall submit a report to the |
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speaker of the house of representatives, lieutenant governor, and |
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appropriate standing committees of the legislature that includes: |
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(1) the cost of the pilot program operated under this |
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chapter; |
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(2) the amount of money collected under the pilot |
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program on behalf of payors; and |
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(3) an evaluation of the effectiveness of the pilot |
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program. |
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Sec. 1222.005. EXPIRATION. This chapter expires September |
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1, 2017. |
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SECTION 2. This Act takes effect September 1, 2015. |