Relating to the form of a claim payment to a health care provider by a health maintenance organization, preferred provider benefit plan, or managed care organization.
HB 3863 requires health insurance plans (including Medicaid managed care organizations) to pay healthcare providers faster for services. Specifically, it mandates payments within 10 days for nursing facility services, 30 days for long-term care, and 45 days for other claims. The bill also prohibits insurers from charging providers fees for electronic payments (like virtual credit cards), though standard bank fees are allowed. Additionally, it requires insurers to establish a system for tracking and resolving provider disputes over unpaid claims. This directly affects doctors, hospitals, and clinics that bill these insurance plans.
Bill status
passed
3 of 5 stages cleared
Introduction
Mar 2025
Committee Review
May 2025
House Passage
May 2025
Senate Passage
Governor
Introduced Mar 27, 2025
Last action May 16, 2025
Maddy AI version diff · 1 comparison
What changed between versions
Introduced
→
Engrossed
·
6 edits
·
May 15, 2025
MODERATE
This bill amends Texas laws to prohibit health plans from requiring physicians or providers to accept claim payments via virtual credit cards or other methods that charge fees for receiving payment. The changes also update payment timelines for different types of claims and add requirements for tracking provider appeals. These updates aim to reduce financial burdens on healthcare providers and ensure timely compensation for services rendered.
Scope change
The bill applies to contracts between health maintenance organizations, preferred provider benefit plans, managed care organizations, and Medicaid managed care organizations, with provisions effective September 1, 2025 for new contracts and claims.
REQUIREMENT
Prohibits health plans from requiring providers to accept payment via virtual credit cards or other methods that assess fees for receiving payment
Requires health plans to develop systems for tracking and resolving provider appeals regarding claims payments
TIMELINE
Updates claim payment deadlines to 45 days for nursing facilities and 30 days for other services, with specific provisions for long-term services
Establishes a 30-day deadline for health plans to pay clean claims at 100% of contracted rates pending audit completion
Adds effective date provisions stating that new requirements apply to contracts and claims submitted on or after September 1, 2025
DEFINITION
Clarifies that nominal bank fees for electronic funds transfers are not considered prohibited fees
Floor votes · House May 15, 2025
How they voted
136–2
Passed · 5 other
Total votes 143
May 15, 2025
D
Democratic59
96% Yea
R
Republican84
94% Yea
Vote distribution
All Yea
All Nay
Mixed
No data
Full legislative history
Actions timeline
Total actions
28
Key actions
7
Committee
7
May 16, 2025
Committee
Referred to Health & Human Services
upper
May 16, 2025
Introduced
Read first time
upper
May 15, 2025
Introduced
Received from the House
upper
May 15, 2025
Lower · Passed
Passed
lower
May 14, 2025
Lower · Passed
Passed to engrossment
lower
May 7, 2025
Lower · Passed
Committee report sent to Calendars
lower
May 7, 2025
Lower · Passed
Committee report distributed
lower
May 2, 2025
Lower · Passed
Reported favorably as substituted
lower
Apr 23, 2025
Lower · Passed
Left pending in committee
lower
Apr 23, 2025
Lower · Passed
Testimony taken/registration(s) recorded in committee
lower
Mar 27, 2025
Committee
Referred to Insurance
lower
Mar 27, 2025
Introduced
Read first time
lower
3 primary · 0 co-sponsors
Sponsors
Role
Legislator
Party
State
District
P
Lacey Hull
RRepublican
P
Terry Canales
DDemocratic
P
Tom Oliverson
RRepublican
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