Texas 2019 - 86th Regular

Texas House Bill HB3041 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	H.B. No. 3041
	1	+	By: Turner of Tarrant, Kacal H.B. No. 3041
	2	+	(Senate Sponsor - Buckingham, Menéndez)
	3	+	(In the Senate - Received from the House May 3, 2019;
	4	+	May 10, 2019, read first time and referred to Committee on Business &
	5	+	Commerce; May 21, 2019, reported favorably by the following vote:
	6	+	Yeas 9, Nays 0; May 21, 2019, sent to printer.)
	7	+	Click here to see the committee vote
2	8
3	9
	10	+	A BILL TO BE ENTITLED
4	11		AN ACT
5	12		relating to the renewal of a preauthorization for a medical or
6	13		health care service.
7	14		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	15		SECTION 1. Subtitle A, Title 8, Insurance Code, is amended
9	16		by adding Chapter 1222 to read as follows:
10	17		CHAPTER 1222. PREAUTHORIZATION FOR MEDICAL OR HEALTH CARE SERVICE
11	18		Sec. 1222.0001. DEFINITIONS. In this chapter:
12	19		(1) "Health benefit plan" means a plan to which this
13	20		chapter applies under Section 1222.0002.
14	21		(2) "Health benefit plan issuer" means an entity
15	22		authorized under this code or another insurance law of this state
16	23		that provides health insurance or health benefits in this state.
17	24		(3) "Preauthorization" has the meaning assigned by
18	25		Section 1301.001.
19	26		Sec. 1222.0002. APPLICABILITY OF CHAPTER. (a) This
20	27		chapter applies only to a health benefit plan that provides
21	28		benefits for medical or surgical expenses incurred as a result of a
22	29		health condition, accident, or sickness, including an individual,
23	30		group, blanket, or franchise insurance policy or insurance
24	31		agreement, a group hospital service contract, or an individual or
25	32		group evidence of coverage or similar coverage document that is
26	33		issued by:
27	34		(1) an insurance company;
28	35		(2) a group hospital service corporation operating
29	36		under Chapter 842;
30	37		(3) a health maintenance organization operating under
31	38		Chapter 843;
32	39		(4) an approved nonprofit health corporation that
33	40		holds a certificate of authority under Chapter 844;
34	41		(5) a multiple employer welfare arrangement that holds
35	42		a certificate of authority under Chapter 846;
36	43		(6) a stipulated premium company operating under
37	44		Chapter 884;
38	45		(7) a fraternal benefit society operating under
39	46		Chapter 885;
40	47		(8) a Lloyd's plan operating under Chapter 941; or
41	48		(9) an exchange operating under Chapter 942.
42	49		(b) Notwithstanding any other law, this chapter applies to:
43	50		(1) a small employer health benefit plan subject to
44	51		Chapter 1501, including coverage provided through a health group
45	52		cooperative under Subchapter B of that chapter;
46	53		(2) a standard health benefit plan issued under
47	54		Chapter 1507;
48	55		(3) a basic coverage plan under Chapter 1551;
49	56		(4) a basic plan under Chapter 1575;
50	57		(5) a primary care coverage plan under Chapter 1579;
51	58		(6) a plan providing basic coverage under Chapter
52	59		1601;
53	60		(7) health benefits provided by or through a church
54	61		benefits board under Subchapter I, Chapter 22, Business
55	62		Organizations Code;
56	63		(8) group health coverage made available by a school
57	64		district in accordance with Section 22.004, Education Code;
58	65		(9) the state Medicaid program, including the Medicaid
59	66		managed care program operated under Chapter 533, Government Code;
60	67		(10) the child health plan program under Chapter 62,
61	68		Health and Safety Code;
62	69		(11) a regional or local health care program operated
63	70		under Section 75.104, Health and Safety Code; and
64	71		(12) a self-funded health benefit plan sponsored by a
65	72		professional employer organization under Chapter 91, Labor Code.
66	73		Sec. 1222.0003. PREAUTHORIZATION RENEWAL REQUEST. A health
67	74		benefit plan issuer that requires preauthorization as a condition
68	75		of payment for a medical or health care service shall provide a
69	76		preauthorization renewal process that allows a renewal of an
70	77		existing preauthorization to be requested by a physician or health
71	78		care provider at least 60 days before the date the preauthorization
72	79		expires.
73	80		Sec. 1222.0004. DETERMINATION REQUIRED. If a health
74	81		benefit plan issuer receives a preauthorization renewal request
75	82		before the existing preauthorization expires, the health benefit
76	83		plan issuer shall, if practicable, review the request and issue a
77	84		determination indicating whether the medical or health care service
78	85		is preauthorized before the existing preauthorization expires.
79	86		SECTION 2. The change in law made by this Act applies only
80	87		to a health benefit plan that is delivered, issued for delivery, or
81	88		renewed on or after January 1, 2020. A health benefit plan that is
82	89		delivered, issued for delivery, or renewed before January 1, 2020,
83	90		is governed by the law as it existed immediately before the
84	91		effective date of this Act, and that law is continued in effect for
85	92		that purpose.
86	93		SECTION 3. This Act takes effect September 1, 2019.
87		-	______________________________ ______________________________
88		-	President of the Senate Speaker of the House
89		-	I certify that H.B. No. 3041 was passed by the House on May 2,
90		-	2019, by the following vote: Yeas 119, Nays 21, 1 present, not
91		-	voting.
92		-	______________________________
93		-	Chief Clerk of the House
94		-	I certify that H.B. No. 3041 was passed by the Senate on May
95		-	22, 2019, by the following vote: Yeas 30, Nays 1.
96		-	______________________________
97		-	Secretary of the Senate
98		-	APPROVED: _____________________
99		-	Date
100		-	_____________________
101		-	Governor
	94	+	* * * * *