Texas Senate Bill SB1188

Texas 2019 - 86th Regular

Caption

Relating to health benefit plan provider networks; providing an administrative penalty; authorizing an assessment.

Impact

The bill imposes a rigorous framework for managing provider directory accuracy, requiring updates within specific timelines following any changes to provider contracts. This means that health benefit plan issuers must remove or list providers in their directories within two business days of relevant contractual changes. The law also mandates ongoing reviews of the directories to ensure continued accuracy, thus aiming to minimize consumer confusion and misrepresentation of provider availability.

Summary

Senate Bill 1188, introduced by Senator Buckingham, addresses the regulatory standards for health benefit plan provider networks in Texas. This legislation amends various sections of the Insurance Code to enhance the requirements for provider directories. A key provision is the requirement for health benefit plan issuers to maintain accurate and accessible information about healthcare providers, including their specialties and whether they are accepting new patients. This aims to increase transparency for consumers when selecting healthcare providers, especially in the context of in-network services.

Contention

One notable point of contention surrounding SB 1188 is determining the costs associated with the administrative penalties it introduces for non-compliance. If a health benefit plan issuer fails to maintain an adequate network due to excessive 'terminations without cause' of healthcare providers, they would face penalties, which may impact their operational costs. Critics of the bill argue that this could lead to higher insurance premiums for consumers as companies might pass on the costs incurred from compliance and penalties. Furthermore, there are concerns regarding the increased bureaucratic oversight and the potential burden it places on insurers to meet the bill's stringent requirements.