Texas Senate Bill SB1186

Texas 2019 - 86th Regular

Caption

Relating to preauthorization of certain medical care and health care services by certain health benefit plan issuers.

Impact

One significant impact of SB1186 is the change to preauthorization processes, mandating that insurers and HMOs notify healthcare providers of any new or amended preauthorization requirements at least 60 days prior to implementation. This change is expected to reduce confusion and streamline medical care delivery, allowing providers and their patients to adjust accordingly. Additionally, by ensuring that all necessary preauthorization information is available online, the bill is set to improve compliance rates and may reduce delays in treatment for patients relying on preauthorized services.

Summary

SB1186 addresses the processes involved in preauthorization for certain medical care and healthcare services as mandated by health benefit plan issuers. The bill aims to enhance transparency and accessibility of preauthorization requirements by requiring health maintenance organizations (HMOs) and insurers to publicly post these requirements online. It emphasizes the need for clear communication to physicians, providers, and insured individuals regarding which services require preauthorization, along with the associated processes. This approach is intended to facilitate better understanding and efficient navigation of the healthcare system for all parties involved.

Contention

Notable points of contention surrounding SB1186 involve the balance between necessary oversight and operational flexibility for health insurers. Proponents argue that the measures in the bill will reduce unnecessary barriers for patients and providers, thereby improving access to care. Conversely, some stakeholders express concern that these requirements could impose added administrative burdens and costs on insurers, which might ultimately be passed on to consumers. Additionally, there are fears that overly stringent preauthorization processes might lead to unintended delays in critical medical services for patients who need them.