Texas 2023 - 88th Regular

Texas House Bill HB2403 Compare Versions

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1	1	88R6515 RDS-F
2	2	By: Paul H.B. No. 2403
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the establishment of the Texas Health Insurance Mandate
8	8	Advisory Review Center; authorizing a fee.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Chapter 38, Insurance Code, is amended by adding
11	11	Subchapter J to read as follows:
12	12	SUBCHAPTER J. TEXAS HEALTH INSURANCE MANDATE ADVISORY REVIEW CENTER
13	13	Sec. 38.451. DEFINITIONS. In this subchapter:
14	14	(1) "Enrollee" means an individual who is enrolled in
15	15	a health benefit plan, including a covered dependent.
16	16	(2) "Health benefit plan issuer" means an insurer,
17	17	health maintenance organization, or other entity authorized to
18	18	provide health benefits coverage under the laws of this state,
19	19	including a Medicaid managed care organization.
20	20	(3) "Health care provider" means a physician,
21	21	facility, or other person who is licensed, certified, registered,
22	22	or otherwise authorized to provide a health care service in this
23	23	state.
24	24	(4) "Health care service" means a service, procedure,
25	25	drug, or device to diagnose, prevent, alleviate, cure, or heal a
26	26	human disease, injury, or unhealthy or abnormal physical or mental
27	27	condition, including a service, procedure, drug, or device related
28	28	to pregnancy or delivery.
29	29	(5) "Mandate" means a provision of a bill or joint
30	30	resolution that requires a health benefit plan issuer to:
31	31	(A) provide coverage for a health care service;
32	32	(B) increase or decrease payments to health care
33	33	providers for a health care service; or
34	34	(C) implement a new contractual or
35	35	administrative requirement.
36	36	(6) "Mandate review center" means the Texas Health
37	37	Insurance Mandate Advisory Review Center established under Section
38	38	38.452.
39	39	Sec. 38.452. ESTABLISHMENT OF MANDATE REVIEW CENTER. The
40	40	Center for Healthcare Data at The University of Texas Health
41	41	Science Center at Houston shall establish the Texas Health
42	42	Insurance Mandate Advisory Review Center to prepare analyses of
43	43	bills and joint resolutions that would impose new mandates on
44	44	health benefit plan issuers in this state.
45	45	Sec. 38.453. REQUEST FOR ANALYSIS OF MANDATE. (a)
46	46	Regardless of whether the legislature is in session, the lieutenant
47	47	governor, the speaker of the house of representatives, or the chair
48	48	of the appropriate committee in either house of the legislature may
49	49	submit a request to the mandate review center to prepare and develop
50	50	an analysis of a proposed or enacted bill or joint resolution that
51	51	imposes a new mandate on health benefit plan issuers in this state.
52	52	(b) A request submitted under this section must include a
53	53	draft of the bill or joint resolution prepared by the Texas
54	54	Legislative Council or a copy of an act of the Texas Legislature.
55	55	Sec. 38.454. ANALYSIS OF MANDATE. (a) On receiving a
56	56	request under Section 38.453, the mandate review center shall
57	57	conduct an analysis of, as applicable, the extent to which:
58	58	(1) the mandate has increased or decreased or is
59	59	expected to increase or decrease total spending in this state for
60	60	any relevant health care service, including the estimated dollar
61	61	amount of that increase or decrease;
62	62	(2) the mandate has increased or is expected to
63	63	increase the utilization of any relevant health care service in
64	64	this state;
65	65	(3) the mandate has increased or decreased or is
66	66	expected to increase or decrease administrative expenses of health
67	67	benefit plan issuers and expenses of enrollees, plan sponsors, and
68	68	policyholders;
69	69	(4) the mandate has increased or decreased or is
70	70	expected to increase or decrease the total spending by all persons
71	71	in the private sector, by public sector entities, including state
72	72	or local retirement systems and political subdivisions, and
73	73	individuals purchasing individual health insurance or health
74	74	benefit plan coverage in this state;
75	75	(5) coverage for any relevant health care service is
76	76	or was, without the mandate, generally available or utilized; or
77	77	(6) any relevant health care service is supported by
78	78	medical and scientific evidence, including:
79	79	(A) determinations made by the United States Food
80	80	and Drug Administration;
81	81	(B) coverage determinations made by the Centers
82	82	for Medicare and Medicaid Services;
83	83	(C) determinations made by the United States
84	84	Preventive Services Task Force; and
85	85	(D) nationally recognized clinical practice
86	86	guidelines.
87	87	(b) In conducting an analysis under this section, the
88	88	mandate review center may consult with persons with relevant
89	89	knowledge and expertise.
90	90	Sec. 38.455. REPORT. Not later than 60 days after receiving
91	91	a request under Section 38.453, the mandate review center shall
92	92	prepare a written report containing the results of the analysis
93	93	performed under Section 38.454 and:
94	94	(1) deliver the report to the lieutenant governor, the
95	95	speaker of the house of representatives, and the appropriate
96	96	committees in each house of the legislature; and
97	97	(2) make the report available on a generally
98	98	accessible Internet website.
99	99	Sec. 38.456. FUNDING OF MANDATE REVIEW CENTER; FEE. (a)
100	100	The department shall assess an annual fee on each health benefit
101	101	plan issuer other than an issuer operating solely as a Medicaid
102	102	managed care organization in the amount necessary to implement this
103	103	subchapter.
104	104	(b) The mandate review center shall develop an annual cost
105	105	estimate of the amount necessary to fund the actual and necessary
106	106	expenses of implementing this subchapter.
107	107	(c) The department shall, in consultation with the mandate
108	108	review center:
109	109	(1) determine the amount of the fee assessed under
110	110	this section; and
111	111	(2) adjust the amount of the fee assessed under this
112	112	section for each state fiscal biennium to address any:
113	113	(A) estimated increase in costs to implement this
114	114	subchapter; or
115	115	(B) deficits incurred during the preceding year
116	116	as a result of implementing this subchapter.
117	117	(d) Not later than August 1 of each year, a health benefit
118	118	plan issuer shall pay the fee assessed under this section to the
119	119	department. The legislature may appropriate money received under
120	120	this section only to The University of Texas Health Science Center
121	121	at Houston to be used by the Center for Healthcare Data to
122	122	administer the center's duties under this subchapter.
123	123	(e) The commissioner shall adopt rules to administer this
124	124	section.
125	125	SECTION 2. Not later than January 1, 2024, the Center for
126	126	Healthcare Data at The University of Texas Health Science Center at
127	127	Houston shall establish the Texas Health Insurance Mandate Advisory
128	128	Review Center as required by Section 38.452, Insurance Code, as
129	129	added by this Act.
130	130	SECTION 3. Not later than January 1, 2024, the commissioner
131	131	of insurance shall adopt rules as required by Section 38.456,
132	132	Insurance Code, as added by this Act.
133	133	SECTION 4. This Act takes effect September 1, 2023.