TITLE: Relating to eligibility for mediation of certain out-of-network health benefit claims.

SUMMARY: Relating to eligibility for mediation of certain out-of-network health benefit claims.

FULL TEXT:
AN ACT relating to eligibility for mediation of certain out-of-network health benefit claims. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Section 1467.054(a), Insurance Code, is amended to read as follows: (a) Not later than the 90th day after the date an out-of-network provider receives an initial payment for a health care or medical service or supply, an [An] out-of-network provider or a health benefit plan issuer or administrator may request mandatory mediation under this subchapter. SECTION 2. (a) The changes in law made by this Act apply to a health care or medical service or supply provided: (1) on or after the 30th day after the effective date of this Act; or (2) before the 30th day after the effective date of this Act, if an out-of-network provider or health benefit plan issuer or administrator requests mandatory mediation under Subchapter B, Chapter 1467, Insurance Code, as amended by this Act, in relation to payment for the service or supply on or before the 120th day after the effective date of this Act. (b) A health care or medical service or supply provided before the 30th day after the effective date of this Act to which Subsection (a) of this section does not apply is governed by the law in effect immediately before the effective date of this Act, and that law is continued in effect for that purpose. SECTION 3. This Act takes effect immediately if it receives a vote of two-thirds of all the members elected to each house, as provided by Section 39, Article III, Texas Constitution.