By: Lucio III H.B. No. 4018
A BILL TO BE ENTITLED
AN ACT
relating to mandatory meetings of the Advisory Committee on Uniform
Prior Authorization Forms.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
Section 1. Subtitle A, Title 8, Chapter 1217, Section
1217.005, Insurance Code, is amended to read as follows:
Sec. 1217.005. ADVISORY COMMITTEE ON UNIFORM PRIOR
AUTHORIZATION FORMS. (a) The commissioner shall appoint a
committee to advise the commissioner on the technical, operational,
and practical aspects of developing the single, standard prior
authorization form required under Section 1217.004 for requesting
prior authorization of health care services, including:
(1) requirements for the health benefit plan issuer or
agent of the health benefit plan issuer to acknowledge receipt of
the standard form;
(2) timelines under which the health benefit plan
issuer or agent of the health benefit plan issuer must acknowledge
receipt of the standard form; and
(3) implications, including administrative penalties,
for the failure of a health benefit plan issuer or agent of a health
benefit plan issuer to:
(A) timely acknowledge receipt of the standard
form; or
(B) use or accept the form.
(b) The commissioner shall consult the advisory committee
with respect to any rule relating to a subject described by Section
1217.004 before adopting the rule and may shall consult the
committee as needed on a quarterly basis with respect to a proposed
or subsequent amendment of an adopted rule.
(c) The advisory committee shall be composed of an equal
number of members from each of the following groups of
stakeholders:
(1) physicians;
(2) health care providers other than physicians;
(3)
hospitals;
(4) representatives of health benefit plans; and
(5) Health and Human Services Commission
Representatives.
(d) A physician may not serve on the advisory committee as a
physician member under Subsection (c)(1) if the physician is or has
been employed by or consults or has consulted for an insurance
company.
(e) A member of the advisory committee serves without
compensation.
(f) Section 39.003(a) of this code and Chapter 2110,
Government Code, do not apply to the advisory committee.
Added by Acts 2015, 84th Leg., R.S., Ch. 1198 (S.B. 1216), Sec. 1,
eff. September 1, 2015.