Texas Senate Bill SB1396

Texas 2009 - 81st Regular

Caption

Relating to required procedures regarding the ranking of physicians by health benefit plan issuers.

Impact

SB1396 will specifically affect how health benefit plans operate within Texas, mandating greater accountability in the ranking of physicians. By enforcing disclosure of ranking criteria, the bill aims to protect physicians from arbitrary or biased evaluations, thus altering the landscape of health benefit plan operations. Affected physicians will now have the legal framework to challenge and contest rankings they believe are unjust or not representative of their practice.

Summary

SB1396 introduces a framework regulating the manner in which health benefit plans rank physicians based on performance metrics. The bill seeks to ensure transparency in physician evaluations by requiring health benefit plan issuers to disclose any objective standards or criteria used in the ranking process prior to evaluations. This ensures that physicians are made aware of how their performance will be assessed, which aims to foster a fair environment for evaluating medical practitioners against their peers.

Contention

While the bill promotes fairness and transparency, it may also create tension between health benefit plan issuers and medical practitioners. There are concerns regarding the potential for increased legal disputes, as physicians may challenge rankings more frequently. Additionally, the statutory requirements for due process could prolong the evaluation process, thus creating uncertainty for both physicians and health consumers regarding access to care and the quality of services provided by ranked physicians.