86R12562 PMO-D
By: Bowers H.B. No. 3178
A BILL TO BE ENTITLED
AN ACT
relating to an interim house study regarding retrospective denial
by health benefit plans of health benefit claims for emergency
care.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. HOUSE COMMITTEE. (a) A standing committee of
the house of representatives shall study and report to the speaker
and members of the house of representatives regarding the practice
of retrospective denial by health benefit plans of health benefit
claims for emergency care.
(b) Not later than the 60th day after the effective date of
this Act, the speaker of the house of representatives shall appoint
an appropriate committee from the standing committees of the house
of representatives to conduct the study and prepare the report
required by Subsection (a) of this section.
SECTION 2. STUDY. The committee selected under Section 1 of
this Act shall, with respect to the practice of retrospective
denial by health benefit plans of health benefit claims for
emergency care, study:
(1) the formal and informal policies of health benefit
plans under which claims for emergency care are denied after the
care has been provided to a covered person;
(2) the effect the retrospective denial practice has
on whether residents of this state seek emergency care;
(3) patient expectations about health benefits that
may be available when seeking emergency care;
(4) the conflict between the application of the
retrospective denial practice and the prudent layperson standard
adopted in this state with respect to emergency care; and
(5) the effect the retrospective denial practice has
on medical debt incurred by residents of this state.
SECTION 3. REPORT. Not later than January 1, 2021, the
committee selected under Section 1 of this Act shall report the
committee's findings and recommendations to the speaker and members
of the house of representatives. The committee shall include in the
recommendations specific statutory changes, including any changes
necessary to Title 8, Insurance Code, that may appear necessary or
advisable from the committee's study conducted under Section 2 of
this Act.
SECTION 4. EXPIRATION. This Act expires September 1, 2021.
SECTION 5. EFFECTIVE DATE. This Act takes effect September
1, 2019.