Texas Senate Bill SB1388

Texas 2017 - 85th Regular

Caption

Relating to the termination by an insurer of a contract with a preferred provider.

Impact

The impact of SB1388 is significant as it alters the regulatory landscape surrounding healthcare provider contracts in Texas. By requiring insurers to provide justifications for contract terminations, the bill aims to protect providers from arbitrary or unfair practices, thereby promoting a more stable healthcare environment. This change is likely to affect how insurers manage their relationships with healthcare providers, ensuring that terminations are justified and invoicing for services is clear to providers.

Summary

SB1388 aims to enhance the protections for preferred healthcare providers regarding contract termination by insurers. Under this bill, insurers are required to provide written reasons for terminating contracts with preferred providers. Additionally, the bill mandates that if a contract is terminated due to issues related to a practitioner, the insurer must offer a reasonable review mechanism upon request, barring circumstances involving imminent patient harm, actions by licensing boards, or fraud. These provisions intend to foster transparency and fairness in the insurance market.

Contention

Notable points of contention revolve around the balance of power between insurers and healthcare providers. Supporters argue that SB1388 protects providers from unjust terminations, allowing them to defend their practices and maintain their professional integrity. However, some opponents may contend that the added bureaucratic processes could create delays in the termination of contracts where necessary, potentially exposing patients to unnecessary risks if inefficient providers are retained due to the new procedural requirements. The implementation of this bill may therefore need careful regulatory oversight to ensure both patient safety and provider rights are maintained.