Relating to telephone access for certain health benefit plan verifications and preauthorization requests and for utilization review requests.
Impact
If enacted, SB1149 would amend several sections of the Texas Insurance Code to require that verification and preauthorization requests are handled 24/7 by HMOs and insurers. This includes ensuring that these organizations have telephone systems capable of handling calls, even when personnel are unavailable. By responding to requests within two hours, the bill aims to minimize the potential delays that patients might face in accessing needed medical care, thereby potentially improving health outcomes.
The sentiment surrounding SB1149 appears to be generally positive, especially among those advocating for improved healthcare access and efficiency. Supporters argue that enhanced communication channels and quicker response times are essential for patient care, while critics, if any, may be concerned about the operational burdens this could place on smaller insurance providers. However, concrete evidence of significant opposition or contention seems sparse based on available documentation.
Contention
While the bill primarily focuses on accessibility and responsiveness, there may be concerns regarding the implications for operational practices within smaller health plans or HMOs. Questions about the feasibility of implementing these requirements, especially for organizations with limited resources, could be central to discussions as the bill moves through legislative processes. Overall, the enactment of SB1149 would mark a significant change in how insurance and healthcare management services are provided in Texas.
Identical
Relating to telephone access for certain health benefit plan verifications and preauthorization requests and for utilization review requests.
Relating to physician and health care provider directories, preauthorization, utilization review, independent review, and peer review for certain health benefit plans and workers' compensation coverage.