Relating to the designation of certain physicians as preferred providers.
Impact
By enacting HB1667, the Texas legislature seeks to streamline the process by which physicians become established as preferred providers. The modification is expected to positively impact both physicians and patients by lowering barriers to provider designation, which could ultimately lead to improved healthcare access. It reinforces the idea that patients should have a more extensive choice of healthcare providers, ideally fostering competition that can enhance service quality and availability.
Summary
House Bill 1667 focuses on the designation of certain physicians as preferred providers within health insurance networks. The bill modifies existing provisions in the Texas Insurance Code to ensure that insurers cannot withhold preferred provider status from physicians who meet certain criteria. Notably, a physician can achieve this designation if they join a contracted preferred provider's practice, apply for designation, and adhere to the associated eligibility requirements. This provision aims to enhance the accessibility of healthcare providers for patients by promoting a wider range of physician options within insurance networks.
Contention
Although specific points of contention around HB1667 were not documented, the implications of designating preferred providers could raise debates among insurers, healthcare providers, and patients alike. Potential concerns might arise regarding the balance of power between insurers and healthcare providers, especially in how designation criteria could be interpreted and enforced. Additionally, discussions might center around the duty of insurers to ensure a sufficiently diverse network of providers while maintaining cost-effectiveness.
Relating to health maintenance organization and preferred provider benefit plan minimum access standards for nonemergency ambulance transport services delivered by emergency medical services providers; providing administrative penalties.
Relating to preferred provider benefit plan out-of-pocket expense credits for payments made by an insured directly to a physician or health care provider.