Texas House Bill HB3828

Texas 2019 - 86th Regular

Caption

Relating to the disclosure of health benefit plan network status of certain physicians and health care practitioners.

Impact

The bill specifically amends sections of the Insurance Code and the Occupations Code to ensure that patients are made aware of any potential out-of-network costs before receiving such care. It applies to health benefit plans issued or renewed after January 1, 2020, and requires clear communication from both HMOs and insurers when preauthorization is required for elective procedures. This change is intended to reduce unexpected medical bills for patients who utilize services from out-of-network providers without prior knowledge.

Summary

House Bill 3828 addresses the transparency of healthcare provider networks by mandating that health maintenance organizations (HMOs) and insurers disclose the network status of physicians and healthcare practitioners at the time of preauthorization for elective medical services. This legislation aims to provide patients with critical information regarding whether the healthcare professionals involved in their treatment are covered by their health benefit plans, thus promoting informed decision-making for patients regarding their healthcare options.

Contention

While the bill has merit in promoting transparency, it may not be without controversy. Industry stakeholders may express concerns about the administrative burden it imposes on healthcare providers and insurers to comply with these disclosure requirements. Additionally, opponents may argue about the timing of the disclosures and how effectively this information can be communicated to patients, especially in urgent care scenarios where immediate decisions are often required.