Bill Text: TX HB4500 | 2023-2024 | 88th Legislature | Enrolled

Texas House Bill 4500 (Prior Session Legislation)

Bill Title: Relating to electronic verification of health benefits by health benefit plan issuers for certain physicians and health care providers.

Spectrum: Partisan Bill (Republican 2-0)

Status: (Passed) 2023-06-13 - Effective on 1/1/24 [HB4500 Detail]

Download: Texas-2023-HB4500-Enrolled.html



	H.B. No. 4500




	AN ACT
	relating to electronic verification of health benefits by health
	benefit plan issuers for certain physicians and health care
	providers.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1. Subtitle A, Title 8, Insurance Code, is amended
	by adding Chapter 1223 to read as follows:
	CHAPTER 1223. VERIFICATION OF HEALTH BENEFITS
	Sec. 1223.001. APPLICABILITY OF CHAPTER. (a) This chapter
	applies only to a health benefit plan that provides benefits for
	medical or surgical expenses incurred as a result of a health
	condition, accident, or sickness, including an individual, group,
	blanket, or franchise insurance policy or insurance agreement, a
	group hospital service contract, or an individual or group evidence
	of coverage or similar coverage document that is issued by:
	(1) an insurance company;
	(2) a group hospital service corporation operating
	under Chapter 842;
	(3) a health maintenance organization operating under
	Chapter 843;
	(4) an approved nonprofit health corporation that
	holds a certificate of authority under Chapter 844;
	(5) a multiple employer welfare arrangement that holds
	a certificate of authority under Chapter 846;
	(6) a stipulated premium company operating under
	Chapter 884;
	(7) a Lloyd's plan operating under Chapter 941; or
	(8) an exchange operating under Chapter 942.
	(b) Notwithstanding any other law, this chapter applies to:
	(1) a small employer health benefit plan subject to
	Chapter 1501, including coverage provided through a health group
	cooperative under Subchapter B of that chapter;
	(2) a standard health benefit plan issued under
	Chapter 1507;
	(3) a basic coverage plan under Chapter 1551;
	(4) a basic plan under Chapter 1575;
	(5) a primary care coverage plan under Chapter 1579;
	(6) a plan providing basic coverage under Chapter
	1601;
	(7) alternative health benefit coverage offered by a
	subsidiary of the Texas Mutual Insurance Company under Subchapter
	M, Chapter 2054;
	(8) group health coverage made available by a school
	district in accordance with Section 22.004, Education Code;
	(9) a regional or local health care program operated
	under Section 75.104, Health and Safety Code; and
	(10) a self-funded health benefit plan sponsored by a
	professional employer organization under Chapter 91, Labor Code.
	(c) This chapter does not apply to the state Medicaid
	program, including the Medicaid managed care program operated under
	Chapter 533, Government Code, or the child health plan program
	operated under Chapter 62, Health and Safety Code.
	Sec. 1223.002. INTERNET WEBSITE FOR VERIFICATION REQUIRED
	FOR EMERGENCY PHYSICIANS AND HEALTH CARE PROVIDERS. (a) A health
	benefit plan issuer shall maintain and make available a secure
	system on the issuer's Internet website that allows a physician or
	health care provider for a hospital or freestanding emergency
	medical care facility to determine at any time:
	(1) whether the physician's or provider's patient is
	covered by the issuer's health benefit plan; and
	(2) the deductible, copayment, or coinsurance for
	which the patient is responsible.
	(b) A health benefit plan issuer may provide the information
	described by Subsection (a) through:
	(1) an existing Internet portal that is available at
	all times; or
	(2) an Internet portal that is:
	(A) provided by a third party contracting with
	the issuer; and
	(B) available at all times.
	SECTION 2. This Act takes effect January 1, 2024.


	______________________________	______________________________
	President of the Senate	Speaker of the House


	I certify that H.B. No. 4500 was passed by the House on May 9,
	2023, by the following vote: Yeas 140, Nays 2, 2 present, not
	voting; and that the House concurred in Senate amendments to H.B.
	No. 4500 on May 26, 2023, by the following vote: Yeas 137, Nays 1,
	2 present, not voting.

	______________________________
	Chief Clerk of the House

	I certify that H.B. No. 4500 was passed by the Senate, with
	amendments, on May 24, 2023, by the following vote: Yeas 31, Nays
	0.

	______________________________
	Secretary of the Senate
	APPROVED: __________________
	Date

	__________________
	Governor