By: Vo H.B. No. 2142
A BILL TO BE ENTITLED
AN ACT
relating to preauthorization requirements and examinations of
certain health benefit plan issuers.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 843.154(f), Insurance Code, is amended
to read as follows:
(f) A health maintenance organization shall pay to the
commissioner a fee in an amount assessed by the commissioner and
paid in accordance with rules adopted by the commissioner for the
expenses of an examination under Section 843.156[(a)] that:
(1) are incurred by the commissioner or under the
commissioner's authority; and
(2) are directly attributable to that examination,
including the actual salaries and expenses of the examiners
directly attributable to that examination, as determined under
rules adopted by the commissioner.
SECTION 2. Section 843.156, Insurance Code, is amended by
adding Subsection (a-1) to read as follows:
(a-1) The commissioner shall examine a health maintenance
organization that uses a preauthorization process for health care
services to determine the health maintenance organization's
compliance with applicable requirements of this Code related to
preauthorization, including requirements in this chapter, Chapter
1222, Chapter 1369, and Chapter 4201. A health maintenance
organization is subject to an examination by the commissioner under
this subsection at least once every year and whenever the
commissioner considers an examination necessary. Documentation
provided to the commissioner during an examination conducted under
this subsection is confidential and is not subject to disclosure as
public information under Chapter 552, Government Code.
SECTION 3. Section 1301.0056, Insurance Code, is amended by
adding Subsection (a-1) to read as follows:
(a-1) The commissioner shall examine an insurer that uses a
preauthorization process for medical care or health care services
to determine the insurer's compliance with applicable requirements
of this Code related to preauthorization, including requirements in
this chapter, Chapter 1222, Chapter 1369, and Chapter 4201. A
insurer is subject to an examination by the commissioner under this
subsection at least once every year and whenever the commissioner
considers an examination necessary.
SECTION 4. This Act takes effect September 1, 2021.