TITLE: Relating to reimbursement under preferred provider benefit plans for services provided by licensed podiatrists.

SUMMARY: Relating to reimbursement under preferred provider benefit plans for services provided by licensed podiatrists.

FULL TEXT:
AN ACT relating to reimbursement under preferred provider benefit plans for services provided by licensed podiatrists. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Section 1301.062, Insurance Code, is amended to read as follows: Sec. 1301.062. PREFERRED PROVIDER CONTRACTS BETWEEN INSURERS AND PODIATRISTS. (a) In this section, "podiatrist" means a podiatrist licensed by the Texas State Board of Podiatric Medical Examiners under Chapter 202, Occupations Code. (b) A preferred provider contract between an insurer and a podiatrist [licensed by the Texas State Board of Podiatric Medical Examiners] must provide that: (1) the podiatrist may request a copy of the coding guidelines and payment schedules applicable to the compensation that the podiatrist will receive under the contract for services; (2) the insurer shall provide a copy of the coding guidelines and payment schedules not later than the 30th day after the date of the podiatrist's request; (3) the insurer may not unilaterally make material retroactive revisions to the coding guidelines and payment schedules; [and] (4) the podiatrist may, practicing within the scope of the law regulating podiatry, furnish x-rays and nonprefabricated orthotics covered by the health insurance policy;and (5) the methodology used to compute the amount of payment or reimbursement for services or procedures covered by the contract is the same as the methodology used to compute the amount of payment or reimbursement when the services or procedures are provided by a physician.SECTION 2. The change in law made by this Act applies only to a preferred provider contract entered into or renewed on or after January 1, 2014. A contract entered into or renewed before January 1, 2014, is governed by the law applicable to the contract immediately before the effective date of this Act, and that law is continued in effect for that purpose. SECTION 3. This Act takes effect September 1, 2013.