TX HB1266

Requires managed care plan issuers to treat physician assistants and advanced practice nurses as in-network providers for payment purposes during the credentialing process when they join an established medical group that already has a contract with the plan

Applies only to PAs and APRNs who become employees of medical groups that already have contracted rates for such providers with the managed care plan

Eligibility requires state licensure in good standing, submission of all required credentialing documentation, agreement to comply with existing contract terms and rates, and written consent from the employing medical group

Protects enrollees by holding them harmless for any difference between in-network and out-of-network costs if the provider ultimately fails to meet credentialing requirements

Allows managed care plan issuers to recover the difference between in-network and out-of-network payment amounts from the medical group if an applicant fails credentialing, while limiting issuer liability for complying with these provisions