Bill Text: TX SB1739 | 2019-2020 | 86th Legislature | Enrolled
Bill Title: Relating to payment for care provided by a chiropractor under certain health benefit plans; providing administrative penalties.
Spectrum: Slight Partisan Bill (Democrat 2-1)
Status: (Passed) 2019-05-22 - Effective on 9/1/19 [SB1739 Detail]
Download: Texas-2019-SB1739-Enrolled.html
| S.B. No. 1739 | ||
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| relating to payment for care provided by a chiropractor under | ||
| certain health benefit plans; providing administrative penalties. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Subchapter I, Chapter 843, Insurance Code, is | ||
| amended by adding Section 843.3042 to read as follows: | ||
| Sec. 843.3042. CHIROPRACTIC SERVICES. (a) A health | ||
| maintenance organization offering a health care plan that covers a | ||
| service that is within the scope of a chiropractor's license may not | ||
| refuse to provide reimbursement to an in-network chiropractor for | ||
| the performance of the covered service solely because the service | ||
| is provided by a chiropractor. | ||
| (b) This section does not require a health maintenance | ||
| organization to cover a particular health care service. | ||
| (c) This section does not affect the right of a health | ||
| maintenance organization to determine whether a health care service | ||
| is medically necessary. | ||
| (d) A health maintenance organization that violates this | ||
| section is subject to an administrative penalty as provided by | ||
| Chapter 84 of not more than $1,000 for each claim that remains | ||
| unpaid in violation of this section. Each day the violation | ||
| continues constitutes a separate violation. | ||
| SECTION 2. Subchapter B, Chapter 1301, Insurance Code, is | ||
| amended by adding Section 1301.0516 to read as follows: | ||
| Sec. 1301.0516. CHIROPRACTIC SERVICES. (a) An insurer | ||
| offering a preferred provider benefit plan that covers a service | ||
| that is within the scope of a chiropractor's license may not refuse | ||
| to provide reimbursement for the performance of the covered service | ||
| solely because the service is provided by a chiropractor. | ||
| (b) This section does not require an insurer to cover a | ||
| particular medical or health care service. | ||
| (c) This section does not affect the right of an insurer to | ||
| determine whether a medical or health care service is medically | ||
| necessary. | ||
| (d) An insurer that violates this section is subject to an | ||
| administrative penalty as provided by Chapter 84 of not more than | ||
| $1,000 for each claim that remains unpaid in violation of this | ||
| section. Each day a violation continues constitutes a separate | ||
| violation. | ||
| SECTION 3. Section 1451.109, Insurance Code, is amended by | ||
| adding Subsection (e) to read as follows: | ||
| (e) A health insurance policy issuer that violates this | ||
| section is subject to an administrative penalty as provided by | ||
| Chapter 84 of not more than $1,000 for each claim that remains | ||
| unpaid in violation of this section. Each day the violation | ||
| continues constitutes a separate violation. | ||
| SECTION 4. The change in law made by this Act applies only | ||
| to a health benefit plan that is delivered, issued for delivery, or | ||
| renewed on or after January 1, 2020. A health benefit plan that is | ||
| delivered, issued for delivery, or renewed before January 1, 2020, | ||
| is governed by the law as it existed immediately before the | ||
| effective date of this Act, and that law is continued in effect for | ||
| that purpose. | ||
| SECTION 5. This Act takes effect September 1, 2019. | ||
| ______________________________ | ______________________________ | |
| President of the Senate | Speaker of the House | |
| I hereby certify that S.B. No. 1739 passed the Senate on May | ||
| 3, 2019, by the following vote: Yeas 30, Nays 1. | ||
| ______________________________ | ||
| Secretary of the Senate | ||
| I hereby certify that S.B. No. 1739 passed the House on May | ||
| 10, 2019, by the following vote: Yeas 129, Nays 12, two present | ||
| not voting. | ||
| ______________________________ | ||
| Chief Clerk of the House | ||
| Approved: | ||
| ______________________________ | ||
| Date | ||
| ______________________________ | ||
| Governor | ||
