Texas 2019 - 86th Regular

Texas House Bill HB923

Caption

Relating to coverage of an alternative treatment after the approval of a utilization review.

Impact

If passed, HB 923 would broaden the scope of health care coverage persisting in state law, allowing individuals the opportunity to access alternative treatment options without the financial burden of denial from insurance providers. This could reshape the landscape of health insurance in Texas, ensuring that policyholders are not limited to traditional treatment paths when alternative solutions are available and FDA-approved.

Summary

House Bill 923 aims to amend the Texas Insurance Code by introducing provisions for coverage of alternative health care services following a utilization review. Specifically, it stipulates that if a health care service is approved through a utilization review process, insurers cannot deny coverage for an alternative treatment that is approved by the FDA for the same condition, provided that the cost of the alternative does not exceed that of the initially approved treatment. This bill is designed to increase patient access to approved alternative therapies, ultimately promoting comprehensive patient care.

Contention

While the bill seeks to enhance treatment options for patients, discussions around its implications highlight potential concerns regarding the definitions of 'alternative health care services' and the consequences of expanding insurance coverage in this manner. Critics may argue that without stringent controls or oversight, the inclusion of alternative treatments could lead to increased costs for insurance providers or a dilution of care standards. Therefore, the bill could face scrutiny over its potential to balance innovative treatments with the overarching need for responsible insurance practices.

Companion Bills

No companion bills found.

Previously Filed As

TX HB4505

Relating to health benefit plan coverage for treatment of autism spectrum disorders.

TX HB5121

Relating to health benefit plan coverage of treatment for chemical dependency.

TX HB3566

Relating to statewide standards for the provision of and health benefit plan coverage of substance use and addiction treatment.

TX HB4713

Relating to group health benefit plan coverage for early treatment of first episode psychosis.

TX SB1220

Relating to group health benefit plan coverage for early treatment of first episode psychosis.

TX HB4506

Relating to health benefit plan coverage for treatment of autism.

TX SB2176

Relating to health benefit plan coverage for treatment of autism.

TX HB1236

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

TX HB5113

Relating to utilization review requirements for a health care service provided by a network physician or provider.

TX HB3948

Relating to coverage for childhood screening, diagnosis, and treatment for dyslexia under certain health benefit plans.

Similar Bills

No similar bills found.