PPO Contracts Will Never Be The Same Again

If passed this legislative session, Texas HB 711 will forever change manage care contracts. Can you hear the BUCA posse thundering towards the upcoming sub-committee hearing…….?

g)  A provider may not:
              (1)  offer to a general contracting entity a provider
 network contract that includes an all-or-nothing, anti-steering,
 anti-tiering, gag, or most favored nation clause;
              (2)  enter into a provider network contract that
 includes an all-or-nothing, anti-steering, anti-tiering, gag, or
 most favored nation clause; or
              (3)  amend or renew an existing provider network
 contract previously entered into with a general contracting entity
 so that the contract as amended or renewed adds or retains an
 all-or-nothing, anti-steering, anti-tiering, gag, or most favored
 nation clause.
        (h)  Any provision in a provider network contract that is an
 all-or-nothing, anti-steering, anti-tiering, gag, or most favored
 nation clause is void and unenforceable. The remaining provisions
 in the provider network contract remain in effect and are
        (i)  A general contracting entity that encourages an
 enrollee to obtain a health care service from a particular
 provider, including offering incentives to encourage enrollees to
 use specific providers, or that introduces or modifies a tiered
 network plan or assigns providers into tiers has a fiduciary duty to
 the enrollee to engage in that conduct only for the primary benefit
 of the enrollee.

88(R) HB 711 – Introduced version – Bill Text (texas.gov)