Texas 2015 - 84th Regular

Texas House Bill HB574

Filed
12/29/14  
Out of House Committee
 
Voted on by House
 
Out of Senate Committee
 
Voted on by Senate
 
Governor Action
 

Caption

Relating to the operation of certain managed care plans with respect to certain physicians and health care providers; amending provisions subject to a criminal penalty.

Impact

By amending existing laws, HB574 significantly bolsters protections for both patients and healthcare providers. It allows patients greater access to out-of-network providers without fear of penalization. The bill is expected to foster a more open dialogue between providers and patients regarding the range of services available, potentially improving patient satisfaction and care outcomes. The changes outlined in the bill seek to align the interests of providers and patients by promoting transparent communication while reducing the administrative barriers that may prevent patients from receiving appropriate care.

Summary

House Bill 574 focuses on the operation of managed care plans in relation to health care providers, particularly physicians. The key provisions of the bill amend the Insurance Code to prohibit health maintenance organizations (HMOs) from terminating a physician's participation solely for informing enrollees about the full range of available health care providers, including out-of-network options. This aims to enhance patient choices by ensuring transparency in the healthcare services available to them. Additionally, the bill includes provisions to prevent insurers from penalizing providers for discussing out-of-network services with patients, thus safeguarding the ability of providers to communicate openly about patient options.

Sentiment

The sentiment around HB574 appears to be largely positive among healthcare professionals and patient advocacy groups, who see the bill as a crucial step towards enhancing patient autonomy and access to medical services. Proponents highlight that the reforms can alleviate some constraints imposed by managed care plans that often limit provider options. However, some sentiments of concern were raised by insurance companies who may view the bill as imposing additional restrictions on their operations and profitability. Overall, the sentiment reflects a support for patient-centered care while balancing the interests of various stakeholders in the health insurance landscape.

Contention

Notable points of contention regarding HB574 center on the balance of interests between health maintenance organizations and providers. Insurance companies may argue that such measures could lead to higher costs and complicate the management of care networks. Critics may also express concern over the possible financial implications of expanded access to out-of-network providers for both insurers and patients. Nonetheless, the legislation aims to ensure that patients are well-informed about their health care choices, a principle that is fundamentally supported in health care discourse.

Companion Bills

TX SB1098

Identical Relating to the operation of certain managed care plans with respect to health care providers.

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