TITLE: Relating to the payment for services provided by certain types of health care practitioners under contracts between the practitioners and managed care health benefit plans.

SUMMARY: Relating to the payment for services provided by certain types of health care practitioners under contracts between the practitioners and managed care health benefit plans.

FULL TEXT:
AN ACT relating to the payment for services provided by certain types of health care practitioners under contracts between the practitioners and managed care health benefit plans. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Subchapter C, Chapter 1451, Insurance Code, is amended by adding Section 1451.1041 to read as follows: Sec. 1451.1041. NONDISCRIMINATORY PAYMENT OF NETWORK PRACTITIONERS. (a) In this section, "managed care plan" means a plan under which a health maintenance organization, preferred provider benefit plan issuer, or other organization provides or arranges for health care benefits to plan participants and requires or encourages plan participants to use health care practitioners the plan designates. (b) In entering into contracts for the provision of health care services to managed care plan participants by health care practitioners eligible to be selected under this subchapter, the issuer of a managed care plan may not differentiate among those types of practitioners in the amount to be paid by the plan issuer, or the method to be used by the plan issuer to compute the amount to be paid by the plan issuer, for the performance of a covered physical modality or procedure that is within the scope of the license of more than one of those types of practitioners. SECTION 2. The change in law made by this Act applies only to contracts entered into or renewed on or after the effective date of this Act. SECTION 3. This Act takes effect September 1, 2013.