Texas Senate Bill SB1795

Texas 2019 - 86th Regular

Caption

Relating to notice by certain managed care entities of changes to reimbursement amounts applicable to certain physicians and health care providers.

Impact

The introduction of SB1795 is intended to protect healthcare providers from unforeseen changes in reimbursement rates that could adversely affect their financial stability. By requiring managed care entities to notify providers of changes ahead of time, the bill is expected to foster a more collaborative and transparent relationship between insurers and healthcare practitioners. This could potentially allow providers to adjust their practices and financial forecasting as necessary, thereby promoting better healthcare delivery and stability in the sector.

Summary

SB1795 aims to enhance transparency in the managed care system by mandating that managed care entities notify contracted physicians and healthcare providers of any changes to reimbursement amounts for services provided. This notification requirement must occur before the effective date of the changes, allowing health care providers to prepare accordingly. Furthermore, the bill stipulates that notification must be sent through trackable means, such as certified mail or specified email, to ensure that providers have verifiable evidence of when they were informed about the alterations in reimbursement policies.

Contention

While the bill is framed as a positive step towards transparency and fairness, there may be points of contention regarding the administrative burdens it places on managed care entities. Opponents could argue that the requirement for notifications could lead to increased operational costs and complexities within managed care organizations. Proponents of the bill would need to address these concerns, ensuring that the benefits of enhanced communication with providers outweigh the potential drawbacks of additional regulatory requirements.