Relating to health services provided to health benefit plan enrollees by certain out-of-network health care providers.
Impact
The impact of HB1930 is significant as it protects enrollees by ensuring they are informed about the status of their health service providers. By mandating pre-service notices, the bill addresses the common issue where patients are unaware of the financial ramifications of receiving care from out-of-network providers. This could lead to a reduction in unexpected medical bills that arise from unanticipated balance billing practices, fostering an environment of informed consent.
Summary
House Bill 1930 aims to enhance transparency regarding out-of-network health care provider services within managed care plans in Texas. The bill amends the Insurance Code to require participating providers to give written notice to enrollees when they refer them to out-of-network providers or when out-of-network services are arranged for them. This notice informs enrollees about the potential financial implications, including that they may be responsible for any costs incurred that are not covered by their managed care plan.
Contention
Notable points of contention surrounding HB1930 revolve around the balance between patient protections and the operational burden placed on healthcare providers. Supporters argue that this measure is essential for fostering greater accountability and transparency in healthcare billing. Critics, however, may raise concerns regarding the implications for provider-patient relationships, particularly in emergency situations where timely information may not be feasible. There could also be worries about the increased administrative requirements for providers in terms of maintaining compliance with the notification process.
Relating to the establishment of the state health benefit plan reimbursement review board and the reimbursement for health care services or supplies provided under certain state-funded health benefit plans.