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A BILL TO BE ENTITLED
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AN ACT
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relating to notice by certain managed care entities of changes to |
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reimbursement amounts applicable to certain physicians and health |
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care providers. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. The heading to Chapter 1453, Insurance Code, is |
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amended to read as follows: |
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CHAPTER 1453. DISCLOSURE OF REIMBURSEMENT GUIDELINES AND AMOUNTS |
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UNDER MANAGED CARE PLAN |
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SECTION 2. Section 1453.001, Insurance Code, is amended by |
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adding Subdivision (4) to read as follows: |
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(4) "Physician" means an individual licensed to |
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practice medicine in this or another state. |
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SECTION 3. Chapter 1453, Insurance Code, is amended by |
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adding Section 1453.004 to read as follows: |
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Sec. 1453.004. NOTICE OF CHANGE TO REIMBURSEMENT AMOUNT. |
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(a) A managed care entity shall provide to each physician and |
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health care provider under contract with the managed care entity |
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notice of any change to a reimbursement amount that will be paid to |
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the physician or health care provider for a good or service provided |
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by the physician or health care provider. The notice must be |
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provided before the effective date of the change. |
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(b) The notice required by this section must be sent: |
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(1) directly to each physician or health care provider |
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that may be affected by the reimbursement amount change; and |
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(2) in a manner that is trackable and indicates the |
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date and time the notice was sent, including: |
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(A) by certified mail, return receipt requested, |
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to the physician's or provider's address; or |
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(B) by e-mail to an e-mail address specified by |
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the physician or provider. |
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SECTION 4. This Act takes effect September 1, 2019. |