TX HB2254

Authorizes preferred provider and exclusive provider benefit plans to contract with primary care physicians (family medicine, internal medicine, pediatrics) using fee-for-service, risk-sharing, capitation, or combination payment arrangements

Primary care physicians entering these contracts are not considered to be engaging in the business of insurance

Prohibits insurers from discriminating against physicians who decline to participate in value-based or capitated arrangements, including by reducing fee schedules or requiring participation as a condition of network membership

Requires contracts to specify performance measures, calculation methods, patient attribution processes, stop-loss thresholds, and provisions for renegotiation if there are material changes in scope or benefits

Prohibits global capitation arrangements and subcontracting under these contracts; physicians may file discrimination complaints with the Texas Department of Insurance

Takes effect immediately with two-thirds legislative vote, otherwise September 1, 2025; passed House 144-0 on May 1, 2025, and Senate 31-0 on May 21, 2025