Relating to the calculation of penalties for violating certain laws governing the prompt payment of claims submitted by a physician or health care provider to certain health benefit plan issuers.

HB 4872 amends Texas Insurance Code sections 843.342 and 1301.137 to change how penalties are calculated when health insurers delay payments to physicians or healthcare providers. It specifies that the "contracted rate" used for penalty calculations must be the usual and customary rate for that service in the provider's geographic area, rather than a potentially lower negotiated rate. This directly affects healthcare providers who submit claims to insurers and insurers who may face penalties for late payments. The change applies only to penalties for claims submitted on or after September 1, 2025.