Bill Text: TX SB2502 | 2023-2024 | 88th Legislature | Introduced
Bill Title: Relating to certain limitations on reimbursements paid for inpatient and outpatient hospital services for certain publicly funded health benefit plan coverage for employees and retirees.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2023-03-23 - Referred to Health & Human Services [SB2502 Detail]
Download: Texas-2023-SB2502-Introduced.html
| By: Kolkhorst | S.B. No. 2502 | |
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| relating to certain limitations on reimbursements paid for | ||
| inpatient and outpatient hospital services for certain publicly | ||
| funded health benefit plan coverage for employees and retirees. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Section 1551.205, Insurance Code, is amended to | ||
| read as follows: | ||
| Sec. 1551.205. MAXIMUM RATES FOR FACILITIES; LIMITATIONS. | ||
| (a) Disregarding any contradictory contract terms or any other law | ||
| to the contrary, any facility, as such term is defined by Section | ||
| 324.001 of the Health and Safety Code, that bills the group | ||
| benefits program, its administering firm, carrier, or their | ||
| designee, for health care services provided to an enrolled employee | ||
| or dependent will never be entitled to a rate for such health care | ||
| services thats exceed the rate established in the applicable rider | ||
| in the General Appropriations Act, Article I, Employees Retirement | ||
| System of Texas. | ||
| (b) A facility shall not discriminate against an employee | ||
| or dependent, or against the program, by refusing, to participate | ||
| in an administering firm's or health coverage plan's network, or by | ||
| refusing to serve an employee or dependent, or by providing health | ||
| care services of a lower standard and quality to an employee or | ||
| dependent than what the facility provides to other similar | ||
| patients, because of the maximum rating schedule imposed by | ||
| subsection (a) of this section. | ||
| (c) The board of trustees may not contract for or provide a | ||
| coverage plan that: | ||
| (1) excludes or limits coverage or services for | ||
| acquired immune deficiency syndrome, as defined by the Centers for | ||
| Disease Control and Prevention of the United States Public Health | ||
| Service, or human immunodeficiency virus infection; | ||
| (2) provides coverage for serious mental illness that | ||
| is less extensive than the coverage provided for any physical | ||
| illness; or | ||
| (3) may provide coverage for prescription drugs to | ||
| assist in stopping smoking at a lower benefit level than is provided | ||
| for other prescription drugs. | ||
| SECTION 2: Section 1575.104, Insurance Code, is amended to read as | ||
| follows: | ||
| Sec. 1575.104. TERMS OF CONTRACT; MAXIMUM RATES FOR | ||
| FACILITIES. (a) A contract for group coverage awarded by the | ||
| trustee must meet the minimum benefit and financial standards | ||
| adopted by the trustee. | ||
| (b) Disregarding any contradictory contract terms or any | ||
| other law to the contrary, any facility, as such term is defined by | ||
| Section 324.001 of the Health and Safety Code, that bills the group | ||
| program, its administrator, carrier, or their designee, for health | ||
| care services provided to an enrolled retiree or dependent will | ||
| never be entitled to a rate for such health care services that | ||
| exceeds the rate established in the applicable rider in the General | ||
| Appropriations Act, Article III, Teacher Retirement System. | ||
| (c) A facility shall not discriminate against a retiree or | ||
| dependent, or against the group program, by refusing to | ||
| participate in a group program administrator's or carrier's | ||
| network, or by refusing to serve a retiree or dependent, or by | ||
| providing health care services of a lower standard and quality to a | ||
| retiree or dependent than what the facility provides to other | ||
| similar patients, because of the maximum rating schedule imposed | ||
| by subsection (b) of this section. | ||
| SECTION 3. Subchapter B, Chapter 1579, Insurance Code, is | ||
| amended by adding Section 1579.0511, Insurance Code, to read as | ||
| follows: | ||
| Sec. 1579.0511. MAXIMUM RATES FOR FACILITIES. (a) | ||
| Disregarding any contradictory contract terms or any other law to | ||
| the contrary, any facility, as such term is defined by Section | ||
| 324.001 of the Health and Safety Code, that bills the program, its | ||
| administering firm, health coverage plan, or their designee, for | ||
| health care services provided to an enrolled employee or dependent | ||
| will never be entitled to a rate for such health care services that | ||
| exceeds the rate established in the applicable rider in the General | ||
| Appropriations Act, Article III, Teacher Retirement System. | ||
| (b) A facility shall not discriminate against an employee | ||
| or dependent, or against the program, by refusing to participate in | ||
| an administering firm's or health coverage plan's network, or by | ||
| refusing to serve an employee or dependent, or by providing health | ||
| care services of a lower standard and quality to an employee or | ||
| dependent than what the facility provides to other similar | ||
| patients, because of the maximum rating schedule imposed by | ||
| subsection (a) of this section. | ||
| SECTION 4. Subchapter B of Chapter 1601, Insurance Code, is | ||
| amended by adding Section 1601.0581, Insurance Code, to read as | ||
| follows: | ||
| Sec. 1601.0581. MAXIMUM RATES FOR FACILITIES. (a) | ||
| Disregarding any contradictory contract terms or any other law to | ||
| the contrary, any facility, as such term is defined by Section | ||
| 324.001 of the Health and Safety Code, that bills the uniform | ||
| program, its administering carrier, or their designee, for health | ||
| care services provided to an enrolled employee, retiree, or | ||
| dependent will never be entitled to a rate for such health care | ||
| services that exceeds the rate established in the applicable rider | ||
| in the General Appropriations Act, Article III, University of | ||
| Texas System and Texas A&M University System. | ||
| (b) A facility shall not discriminate against an employee, | ||
| retiree, or dependent, or against the uniform program, by refusing | ||
| to participate in an administering carrier's network, or by | ||
| refusing to serve an employee, retiree, or dependent, or by | ||
| providing health care services of a lower standard and quality to an | ||
| employee, retiree, or dependent than what the facility provides to | ||
| other similar patients, because of the maximum rating schedule | ||
| imposed by subsection (a) of this section. | ||
| SECTION 4. The maximum rating schedules imposed by Section | ||
| 1551.202, Insurance Code, Section 1575.104, Insurance Code, as | ||
| amended by this Act, Section 1579.0511, Insurance Code, and Section | ||
| 1601.0581, Insurance Code, as added by this Act, shall apply to any | ||
| bill for health care services provided by a facility with dates of | ||
| service beginning on or after September 1, 2024. | ||
| SECTION 5. This Act takes effect on September 1, 2023. | ||
