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TX SB267
Bill
Status
11/12/2024
Primary Sponsor
Charles Perry
Click for details
AI Summary
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Requires managed care plans to designate any licensed Texas physician as a participating (in-network) provider upon application, without conditions or ability to refuse
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Sets mandatory reimbursement rate for physicians joining networks through this process at 90% of the highest contracted rate the plan pays for the same service
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Applies to health maintenance organizations, preferred provider plans, state employee health plans (Chapters 1551, 1575, 1579, 1601), CHIP, and Medicaid managed care programs
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Excludes physicians holding only administrative medicine licenses from the definition of "physician" eligible for this designation
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Takes effect September 1, 2025, and applies to health benefit plans delivered, issued, or renewed on or after January 1, 2026
Legislative Description
Relating to unconditional designation of physicians as participating providers in a managed care plan.
PHYSICIANS
Last Action
Referred to Health & Human Services
2/3/2025