Bill Text: TX SB1723 | 2023-2024 | 88th Legislature | Introduced
Bill Title: Relating to the backdating of referrals for certain managed care health benefit plans.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2023-04-26 - Left pending in committee [SB1723 Detail]
Download: Texas-2023-SB1723-Introduced.html
88R3585 CJD-D | ||
By: Paxton | S.B. No. 1723 |
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relating to the backdating of referrals for certain managed care | ||
health benefit plans. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subtitle C, Title 8, Insurance Code, is amended | ||
by adding Chapter 1276 to read as follows: | ||
CHAPTER 1276. REFERRAL REQUIREMENTS | ||
Sec. 1276.001. APPLICABILITY OF CHAPTER. (a) This chapter | ||
applies only to a health benefit plan, including a plan provided by | ||
a health maintenance organization operating under Chapter 843 or a | ||
preferred provider benefit plan issued under Chapter 1301, that | ||
requires a primary care physician or other participating health | ||
care provider to provide a referral to an enrollee as a condition of | ||
payment or for the enrollee to receive a network benefit. | ||
(b) Notwithstanding any other law, this chapter applies to: | ||
(1) a basic coverage plan under Chapter 1551; | ||
(2) a basic plan under Chapter 1575; | ||
(3) a primary care coverage plan under Chapter 1579; | ||
and | ||
(4) basic coverage under Chapter 1601. | ||
(c) Notwithstanding any other law, this chapter applies to | ||
coverage under: | ||
(1) the child health plan program under Chapter 62, | ||
Health and Safety Code; and | ||
(2) a Medicaid managed care program operated under | ||
Chapter 533, Government Code. | ||
Sec. 1276.002. BACKDATED REFERRALS. For purposes of | ||
payment or the provision of network benefits for a health care | ||
service provided to an enrollee, a health benefit plan issuer or | ||
administrator shall accept a referral made by the enrollee's | ||
primary care physician or another participating health care | ||
provider authorized under the enrollee's health benefit plan to | ||
make the required referral if the referral is provided not later | ||
than the 30th day after the date on which the enrollee receives the | ||
service or supply. | ||
SECTION 2. The change in law made by this Act applies only | ||
to a health benefit plan delivered, issued for delivery, or renewed | ||
on or after January 1, 2024. | ||
SECTION 3. This Act takes effect September 1, 2023. |