Texas Eyes Cash Pay Health Plan Legislation?

Texas HB 633, if passed during this year’s legislative session, will provide broad application for Cash Pay Centric Health Plans, a growing market phenomenon. Cash pay health plans are the future of health care finance.

DIRECT PAYMENT OF PHYSICIAN OR HEALTH CARE PROVIDER

Sec. 1204.303.  PAYMENT IN LIEU OF CLAIM FOR BENEFITS; OTHER 
 DIRECT PAYMENTS. (a) A physician or health care provider may not
 be prohibited from accepting directly from an enrollee full payment
 for a health care service in lieu of submitting a claim to the
 enrollee’s health benefit plan.

(b)  Notwithstanding Section 552.003 or any other law, the

              charge for a health care service for which a physician or health

              care provider accepts a payment as described by Subsection (a) or

              from a patient without a health benefit plan may not exceed the

              lowest contract rate for the health care service allowable under

              any health benefit plan with respect to which the physician or

              health care provider is a contracted, preferred, or participating

              provider.

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