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A BILL TO BE ENTITLED
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AN ACT
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relating to preferred provider benefit plan out-of-pocket expense |
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credits for payments made by an insured directly to a physician |
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providing direct primary care. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1301.140, Insurance Code, is amended by |
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adding Subsection (a-1) to read as follows: |
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(a-1) For purposes of Subsection (a), an insurer who |
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provides coverage for primary care services shall treat a direct |
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fee charged by a physician who provides direct primary care as a fee |
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for a medically necessary covered medical or health care service or |
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supply. In this subsection, "direct fee" and "direct primary care" |
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have the meanings assigned by Section 162.251, Occupations Code. |
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SECTION 2. Section 1301.140(a-1), Insurance Code, as added |
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by this Act, applies only to a preferred provider benefit plan that |
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is delivered, issued for delivery, or renewed on or after January 1, |
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2026. |
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SECTION 3. This Act takes effect September 1, 2025. |