The bill, S.B. No. 1014, introduces new provisions to the Texas Insurance Code regarding health care services contract arrangements between insurers and primary care physicians or physician groups. It adds Section 1301.0065, which clarifies that value-based and capitated payment arrangements with primary care providers are not prohibited. The section defines "primary care physician" and "primary care physician group," and outlines the types of payment arrangements that can be made, including fee-for-service, risk-sharing, and capitation. Importantly, it states that primary care providers entering into these contracts will not be considered as engaging in the business of insurance and cannot be discriminated against by insurers for opting out of such arrangements.

Additionally, the bill mandates that contracts involving value-based or capitated payments must not create disincentives for providing necessary health care services and must include specific provisions regarding performance measures, patient attribution, and payment structures. It also prohibits global capitation arrangements and ensures that the parties involved in these contracts cannot subcontract. The bill is set to take effect immediately upon receiving a two-thirds vote from both houses of the legislature or on September 1, 2025, if such a vote is not achieved.

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