Relating to payment of health benefit claims in coordination with third-party liability insurance.
If passed, HB3064 would significantly impact the operations of health benefit plan issuers in Texas, establishing a requirement for them to prioritize and expedite claims related to health benefits. The bill stipulates that health benefit plans must comply with these new rules starting from January 1, 2020, which means any health plan issued or renewed from that date onward must adhere to this provision. The legislation is framed as a consumer protection measure that seeks to reduce financial burdens on patients often faced in transitional recovery scenarios after an accident or health episode.
House Bill 3064 aims to amend Chapter 1203 of the Texas Insurance Code to ensure that health benefit plans do not delay payment of claims based on the possibility that an enrollee might recover costs from a third-party liability insurance policy. This legislation is targeted at promoting timely healthcare coverage for individuals who may have suffered injuries or health conditions that could potentially lead to claims against other insurers. By enacting this bill, lawmakers seek to protect enrollees from the complications and delays that might arise due to overlapping insurance claims.
While the bill is generally positioned positively, there may be concerns amongst insurers about the potential financial implications of this requirement. Insurance companies may argue that the provisions could lead to increased costs due to being obligated to pay claims promptly, regardless of other liable parties’ involvement. The bill has faced scrutiny regarding how it might interact with existing obligations of health benefit issuers and the operational adjustments they would be required to make in light of the new law.