HB4603 - Relating to eligibility for mediation of certain out-of-network health benefit claims.

  89R23190 SCF-F     By: Morgan H.B. No. 4603     Substitute the following for H.B. No. 4603:     By:  Dean C.S.H.B. No. 4603       A BILL TO BE ENTITLED   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.  If this   Act does not receive the vote necessary for immediate effect, this   Act takes effect September 1, 2025.