Texas House Bill HB4519

Texas 2009 - 81st Regular

• Out of House Committee: 5/8/09
• Voted on by House: 5/18/09
• Out of Senate Committee: 5/23/09
• Voted on by Senate: 5/27/09
• Governor Action: 6/19/09
• Enrolled: 5/28/09
• Passed: 6/19/09

Caption

Relating to standards for independent review organizations.

Impact

If enacted, HB 4519 will significantly impact the way IROs operate in the state of Texas. By ensuring that IROs cannot be owned by the same individuals or entities, the bill aims to create a more level playing field for various organizations. Furthermore, the requirement for all IROs to have their primary offices located in Texas is expected to lead to a more localized oversight and accountability structure, potentially improving service quality and response times for patient reviews.

Summary

House Bill 4519 establishes new standards for independent review organizations (IROs) in Texas. The primary aim of the bill is to enhance the integrity and reliability of IROs that are involved in reviewing healthcare claims and procedures. It introduces regulations such as restricting multiple ownership of organizations, mandating that IROs be based and licensed in Texas, and setting criteria for board members. These provisions are designed to prevent conflicts of interest and ensure that IROs operate fairly and within the law.

Contention

Notable points of contention surrounding HB 4519 include concerns about the practicality of some provisions, such as the limitations on ownership and the implications for existing IROs. Some stakeholders fear that the new standards may reduce the number of organizations available for reviews, leading to longer wait times for patients seeking appeal decisions. Additionally, the restrictions on board members and their past affiliations with IROs that lost licenses may be seen as overly punitive by certain stakeholders, prompting debates about the balance between regulation and operational freedom.