Texas 2019 - 86th Regular

Texas House Bill HB4351

Caption

Relating to utilization review of and health benefit plan coverage for emergency care.

Impact

The potential impact of HB4351 is significant for both consumers and health care providers in Texas. By mandating coverage for emergency care necessary to screen and stabilize patients, the bill seeks to protect health benefit plan enrollees from unexpected and often exorbitant costs related to emergency situations. Additionally, the requirement for retrospective reviews of denied emergency care claims adds a layer of accountability for health benefit plan issuers, thereby improving transparency and fairness in the utilization review process.

Summary

House Bill 4351 aims to amend existing state law concerning health benefit plans specifically related to the coverage and utilization review of emergency care. The bill stipulates that health benefit plan issuers must adhere to specific guidelines when determining the necessity and appropriateness of emergency care services. It emphasizes that prior authorization for emergency care cannot be required, thus ensuring that enrollees can receive necessary emergency medical attention without bureaucratic delays.

Contention

Notable points of contention surrounding the bill center on the implications it carries for health insurers and enrollees alike. Supporters argue that the bill will enhance access to necessary medical services in critical situations, potentially saving lives. However, some stakeholders express concerns that the inability to require prior authorization may lead to increased costs for insurers, which could eventually translate into higher premiums for consumers. The ongoing dialogue will likely address these economic implications as the bill progresses through the legislative process.

Companion Bills

No companion bills found.

Previously Filed As

TX HB1128

Relating to availability of and benefits provided under health benefit plan coverage.

TX HB4912

Relating to availability of and benefits provided under health benefit plan coverage.

TX HB4500

Relating to electronic verification of health benefits by health benefit plan issuers for certain physicians and health care providers.

TX SB863

Relating to electronic verification of health benefits by health benefit plan issuers for certain physicians and health care providers.

TX HB1647

Relating to health benefit plan coverage of clinician-administered drugs.

TX SB989

Relating to health benefit plan coverage for certain biomarker testing.

TX HB3188

Relating to health benefit plan coverage for certain biomarker testing.

TX SB1138

Relating to health benefit plan coverage of clinician-administered drugs.

TX HB1236

Relating to the definition of and certain determinations regarding emergency care for purposes of certain health benefit plan coverage.

TX HB526

Relating to HIV and AIDS tests and to health benefit plan coverage of HIV and AIDS tests.

Similar Bills

No similar bills found.