Texas Senate Bill SB1286

Texas 2023 - 88th Regular

• Filed: 2/28/23
• Out of Senate Committee: 4/6/23
• Voted on by Senate: 4/20/23
• Out of House Committee: 5/1/23
• Voted on by House: 5/5/23
• Governor Action: 5/19/23

Caption

Relating to prompt payment deadlines for health benefit plan claims affected by a catastrophic event.

Impact

The amendments proposed by SB1286 clarify the conditions under which healthcare providers can request extensions for submitting claims related to catastrophic events. It allows for the commissioner to publish notices or approve requests that extend deadlines, thus creating a more adaptive regulatory environment for health plans and providers. This change is particularly significant in the wake of natural disasters or emergencies, enabling providers to focus on immediate response and recovery without the constant pressure of developing immediate claims.

Summary

Senate Bill 1286 addresses the prompt payment deadlines for health benefit plan claims that are impacted by catastrophic events. This bill amends sections of the Insurance Code to ensure that health care providers and physicians are not penalized for delays in claim submission due to circumstances outside their control, such as disasters that disrupt normal business operations. The legislation aims to provide flexibility in claim submission timelines during such events, recognizing the unique challenges healthcare providers face in crisis situations.

Sentiment

Overall, the sentiment surrounding SB1286 appears to be largely supportive. The measure has been received positively by legislators across party lines, as evidenced by its unanimous passage in both the Senate and House votes. Supporters argue that this bill is a necessary update to the existing regulatory framework, ensuring that healthcare providers are not unfairly penalized in times of crisis. However, there are concerns about potential abuse of the extension provisions, which some fear could lead to delayed payments for necessary services.

Contention

One notable point of contention related to SB1286 revolves around how broadly the term 'catastrophic event' will be interpreted, and whether this legislation adequately safeguards against potential misuse. While intended to protect healthcare providers, the bill's open-ended provisions could potentially create loopholes for delaying claims under less urgent circumstances. Ensuring that there are clear and enforceable boundaries around these extensions will be crucial to the bill's implementation.

Texas Constitutional Statutes Affected

Insurance Code

• Chapter 843. Health Maintenance Organizations
  • Section: 337
  • Section: 342
  • Section: 337
  • Section: 342
  • Section: 337
  • Section: 342
  • Section: 337
  • Section: 342
  • Section: 337
  • Section: 342

• Chapter 1301. Preferred Provider Benefit Plans
  • Section: 102
  • Section: 137
  • Section: 102
  • Section: 137
  • Section: 102
  • Section: 137
  • Section: 102
  • Section: 137
  • Section: 102
  • Section: 137