The bill, S.B. No. 1014, amends the Texas Insurance Code by adding Section 1301.0065, which establishes guidelines for value-based and capitated payment arrangements between insurers and primary care physicians or physician groups. It defines "primary care physician" and "primary care physician group," allowing insurers to contract with these providers through various payment models, including fee-for-service, risk-sharing, and capitation arrangements. Importantly, the bill clarifies that primary care physicians or groups entering into these contracts are not considered to be engaging in the business of insurance and cannot be discriminated against by insurers for opting out of such arrangements.

Additionally, the bill outlines specific requirements for contracts involving value-based or capitated payments, ensuring that they do not create disincentives for providing necessary health care services and that they respect the physician's medical judgment. It mandates transparency in performance measures and allows for complaints to be filed if discrimination occurs. However, it explicitly prohibits global capitation arrangements under these contracts and states that parties involved cannot subcontract. The bill is set to take effect immediately upon receiving a two-thirds vote from both houses or on September 1, 2025, if that threshold is not met.

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