TX HB4549

Extends the deadline for health maintenance organizations (HMOs) and insurers to recover overpayments from physicians or providers from 180 days to one year after the provider receives payment

Allows HMOs and insurers to extend claim payment deadlines and recover overpayments at any time if they suspect the claim was submitted fraudulently or based on misrepresentation, provided investigations are conducted in good faith

Requires HMOs and insurers to request additional attachments or information from third parties within 30 calendar days of receiving a clean claim, with payment determinations due within 15 days of receiving the requested information

Restricts physicians and providers from recovering attorney's fees and court costs in payment disputes to only cases where the HMO or insurer acted in bad faith in making the payment determination

Defines "billed charges" as the lowest rate a preferred provider will accept directly from a patient as payment in full for services