Texas Senate Bill SB1740

Texas 2019 - 86th Regular

Caption

Relating to disclosures by certain health benefit plans to enrollees regarding certain preauthorized medical care and health care services.

Impact

SB1740 modifies existing laws under the Texas Insurance Code to mandate these disclosures, thereby enhancing the rights of consumers concerning their healthcare options. By specifying the necessary information that HMOs and insurers must provide, the bill is expected to reduce unexpected financial burdens on patients. This could potentially lead to increased patient satisfaction and less confusion about healthcare expenses as individuals approach their treatment dates. The law would apply only to health benefit plans delivered, issued for delivery, or renewed on or after January 1, 2020.

Summary

Senate Bill 1740 aims to improve transparency in the preauthorization process for elective healthcare services. The bill requires health maintenance organizations (HMOs) and insurers to provide enrollees with specific information regarding any preauthorized medical services well in advance of their scheduled procedure. This includes details about the providers involved, an estimate of the expected payment for those services, and a clear statement of the enrollee's financial obligations, such as copayments or deductibles. The introduction of this measure is intended to empower patients by equipping them with essential details about their healthcare costs ahead of time.

Contention

During the discussions surrounding SB1740, some pointed out that while the bill promotes greater transparency, certain stakeholders, such as healthcare providers and insurers, expressed concerns about the feasibility of compiling the required estimates and maintaining accuracy concerning network status. The potential for inconsistencies in estimation due to varying medical conditions and circumstances was also highlighted as a point of contention. Nevertheless, proponents argued that the overall benefits of increased clarity and the potential for improved financial planning for patients outweigh these logistical concerns.