Texas 2019 - 86th Regular

Texas House Bill HB2520

Caption

Relating to disclosures by certain health benefit plans to enrollees regarding certain preauthorized medical care and health care services.

Impact

The implementation of HB2520 is designed to adjust existing regulations within the Insurance Code, particularly regarding the requirements for health maintenance organizations and insurance providers. By enforcing these disclosure requirements, the bill is expected to foster greater accountability among providers and improve the informed decision-making process for patients regarding their health care. The changes may lead to improved financial transparency and patient satisfaction over time as enrollees gain better foresight into their healthcare expenses.

Summary

House Bill 2520 aims to enhance transparency in healthcare by mandating that certain health benefit plans provide disclosures to enrollees regarding preauthorized medical care and health care services. Specifically, the bill requires health maintenance organizations (HMOs) and insurers to inform enrollees about the expected providers for elective services that require preauthorization. This initiative seeks to clarify the financial implications for patients and help them understand their potential out-of-pocket costs associated with medical services before receiving care.

Sentiment

The sentiment surrounding HB2520 has generally been positive among advocates for consumer rights and healthcare reform. Supporters argue that the bill is a crucial step toward greater fairness and clarity in the healthcare system, which can alleviate surprise medical bills for patients. However, there may be concerns from insurance providers about the administrative burden that additional disclosure requirements could impose, leading to a mixed reception among stakeholders.

Contention

Notable points of contention within discussions surrounding HB2520 often relate to the potential challenges in accurately predicting the costs associated with preauthorized services. Critics might argue that while the intentions of the bill are commendable, the complexity of healthcare billing and the variability of service provision could render the disclosures less effective. Additionally, the question of whether these disclosures adequately address the issue of out-of-network providers remains a focal point of debate. Stakeholders continue to discuss the balance between transparency and the operational realities of healthcare delivery.

Companion Bills

TX SB1740

Same As Relating to disclosures by certain health benefit plans to enrollees regarding certain preauthorized medical care and health care services.

Previously Filed As

TX HB757

Relating to preauthorization of certain benefits by certain health benefit plan issuers.

TX SB2476

Relating to consumer protections against certain medical and health care billing by emergency medical services providers.

TX HB4343

Relating to health benefit plan preauthorization requirements for certain health care services and the direction of utilization review by physicians.

TX HB4367

Relating to the preauthorization of medical or health care services by a health maintenance organization or an insurer.

TX HB5186

Relating to the establishment of the state health benefit plan reimbursement review board and the reimbursement for health care services or supplies provided under certain state-funded health benefit plans.

TX HB3034

Relating to notice regarding nonemergency ambulance and certain nonemergency health care coverage in health benefit plans.

TX SB622

Relating to the disclosure of certain prescription drug information by a health benefit plan.

TX HB1754

Relating to the disclosure of certain prescription drug information by a health benefit plan.

TX HB826

Relating to modification of certain prescription drug benefits and coverage offered by certain health benefit plans.

TX SB1221

Relating to modification of certain prescription drug benefits and coverage offered by certain health benefit plans.

Similar Bills

TX HB4012

Relating to an explanation of benefits provided by certain health benefit plans to enrollees regarding certain preauthorized medical care and health care services.

TX HB3459

Relating to preauthorization requirements for certain health care services and utilization review for certain health benefit plans.

NY S07470

Requires insurers and health plans to grant automatic preauthorization approvals to eligible health care professionals in certain circumstances.

MS HB866

Mississippi Preauthorization Gold Card Act; enact.

DC B25-0578

Game On: Providing Leisure Activities for Youth Amendment Act of 2023

TX SB1740

Relating to disclosures by certain health benefit plans to enrollees regarding certain preauthorized medical care and health care services.

TX HB3429

Relating to preauthorization of certain medical services in the workers' compensation system and the eligibility of doctors, dentists, and chiropractors to perform preauthorization utilization review.

NJ A4431

Prohibits preauthorization of certain ultrasound screenings covered under health benefits plans.