Texas HB4872 amends the Insurance Code to redefine the contracted rate for calculating penalties for late payments to physicians and health care.

Texas HB4872 amends the Insurance Code to redefine the contracted rate for calculating penalties for late payments to physicians and health care providers. Specifically, it sets the contracted rate as the usual and customary rate for services in the geographic area. The changes apply to penalties or interest on penalties for claims submitted after the Act's effective date, which is September 1, 2025. This affects health benefit plan issuers and the physicians or health care providers who submit claims to them.

Texas HB4872 amends the Insurance Code to redefine the contracted rate for calculating penalties for late payments to physicians and health care.

Texas HB4872 amends the Insurance Code to redefine the contracted rate for calculating penalties for late payments to physicians and health care providers. Specifically, it sets the contracted rate as the usual and customary rate for services in the geographic area. The changes apply to penalties or interest on penalties for claims submitted after the Act's effective date, which is September 1, 2025. This affects health benefit plan issuers and the physicians or health care providers who submit claims to them.