Texas Senate Bill SB245

Texas 2021 - 87th Regular

Caption

Relating to the adequacy and effectiveness of managed care plan networks.

Impact

The legislation proposes significant changes to the Texas Insurance Code, providing the office of public insurance counsel the authority to assess, advocate for, and monitor the adequacy of managed care plan networks. By implementing requirements for annual consumer report cards, managed care plans will be evaluated based on objective criteria, allowing consumers to make informed choices regarding their healthcare options. This shift not only potentially improves healthcare accessibility but also enhances consumer trust in managed care systems.

Summary

SB245 aims to enhance the adequacy and effectiveness of managed care plan networks in Texas. It modifies existing laws to empower the office of public insurance counsel in monitoring and advocating for consumers regarding managed care plans. The bill emphasizes the importance of having adequate healthcare networks available to consumers, potentially addressing existing shortcomings in access and quality of care offered by these plans.

Contention

Notable points of contention surrounding SB245 include concerns about the feasibility of implementing these evaluations and the impact on managed care organizations. Critics might argue that increased scrutiny and requirements for transparency could lead to increased costs for managed care plans, which in turn could affect premiums and overall healthcare prices for consumers. Furthermore, the implications of such rigorous oversight could lead to a further consolidation within the managed care industry as smaller organizations may struggle to meet the new demands.