Texas 2025 - 89th Regular

Texas House Bill HB1906 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	89R4581 RDS-F
2	2	By: Paul H.B. No. 1906
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7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to the establishment of the Health Impact, Cost, and
10	10	Coverage Analysis Program; authorizing a fee.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Chapter 38, Insurance Code, is amended by adding
13	13	Subchapter J to read as follows:
14	14	SUBCHAPTER J. HEALTH IMPACT, COST, AND COVERAGE ANALYSIS PROGRAM
15	15	Sec. 38.451. DEFINITIONS. In this subchapter:
16	16	(1) "Analysis program" means the Health Impact, Cost,
17	17	and Coverage Analysis Program established under Section 38.452.
18	18	(2) "Center" means the Center for Health Care Data at
19	19	The University of Texas Health Science Center at Houston.
20	20	(3) "Enrollee" means an individual who is enrolled in
21	21	a health benefit plan, including a covered dependent.
22	22	(4) "Health benefit plan issuer" means an insurer,
23	23	health maintenance organization, or other entity authorized to
24	24	provide health benefits coverage under the laws of this state,
25	25	including a Medicaid managed care organization. The term does not
26	26	include an issuer of workers' compensation insurance.
27	27	(5) "Health benefits coverage" does not include
28	28	workers' compensation.
29	29	(6) "Health care provider" means a physician,
30	30	facility, or other person who is licensed, certified, registered,
31	31	or otherwise authorized to provide a health care service in this
32	32	state.
33	33	(7) "Health care service" means a service, procedure,
34	34	drug, or device to diagnose, prevent, alleviate, cure, or heal a
35	35	human disease, injury, or unhealthy or abnormal physical or mental
36	36	condition, including a service, procedure, drug, or device related
37	37	to pregnancy or delivery.
38	38	(8) "Mandate" means a provision contained in a
39	39	legislative document that requires a health benefit plan issuer or
40	40	administrator, with respect to health benefits coverage, to:
41	41	(A) provide coverage for a health care service;
42	42	(B) increase or decrease payments to health care
43	43	providers for a health care service; or
44	44	(C) implement a new contractual or
45	45	administrative requirement.
46	46	Sec. 38.452. ESTABLISHMENT OF HEALTH IMPACT, COST, AND
47	47	COVERAGE ANALYSIS PROGRAM. The center shall establish the Health
48	48	Impact, Cost, and Coverage Analysis Program to prepare analyses of
49	49	legislative documents that would impose new mandates on health
50	50	benefit plan issuers or administrators in this state.
51	51	Sec. 38.453. REQUEST FOR ANALYSIS OF PROPOSED LEGISLATION.
52	52	(a) Regardless of whether the legislature is in session, the
53	53	lieutenant governor, the speaker of the house of representatives,
54	54	or the chair of the appropriate committee in either house of the
55	55	legislature may submit a request to the analysis program to prepare
56	56	and develop an analysis of proposed legislation that imposes a new
57	57	mandate on health benefit plan issuers or administrators in this
58	58	state.
59	59	(b) A request may not be submitted under this section for an
60	60	analysis of legislation that has already been enacted.
61	61	(c) A request submitted under this section must include a
62	62	copy of the relevant legislative document.
63	63	Sec. 38.454. IMPACT ANALYSIS OF LEGISLATION ON HEALTH
64	64	COVERAGE COSTS. (a) Except as provided by Subsection (b), on
65	65	receiving a request under Section 38.453, the analysis program
66	66	shall conduct an analysis of, as applicable, and prepare an
67	67	estimate of, as applicable, the extent to which:
68	68	(1) the legislation is expected to increase or
69	69	decrease the total cost of health coverage in this state, including
70	70	the estimated dollar amount of that increase or decrease;
71	71	(2) the legislation is expected to increase the use of
72	72	any relevant health care service in this state;
73	73	(3) the legislation is expected to increase or
74	74	decrease administrative expenses of health benefit plan issuers or
75	75	administrators and expenses of enrollees, plan sponsors, and
76	76	policyholders;
77	77	(4) the legislation is expected to increase or
78	78	decrease spending by all persons in the private sector, by public
79	79	sector entities, including state or local retirement systems and
80	80	political subdivisions, and by individuals purchasing individual
81	81	health insurance or health benefit plan coverage in this state;
82	82	(5) the legislation is expected to reduce:
83	83	(A) instances of premature death; or
84	84	(B) economic loss associated with disease;
85	85	(6) health benefit plans offered or administered in
86	86	this state currently deny access to a relevant benefit or service;
87	87	(7) coverage for any relevant health care service is,
88	88	without the legislation, generally available or used; or
89	89	(8) any relevant health care service is supported by
90	90	medical and scientific evidence, including:
91	91	(A) determinations made by the United States Food
92	92	and Drug Administration;
93	93	(B) coverage determinations made by the Centers
94	94	for Medicare and Medicaid Services;
95	95	(C) determinations made by the United States
96	96	Preventive Services Task Force; and
97	97	(D) nationally recognized clinical practice
98	98	guidelines.
99	99	(b) If, in conducting an analysis under this section, the
100	100	analysis program determines that the analysis program is unable to
101	101	provide a reliable assessment of a factor described by Subsection
102	102	(a), the analysis program shall include in the analysis a statement
103	103	providing the basis for that determination.
104	104	(c) In conducting an analysis under this section, the
105	105	analysis program may consult with persons with relevant knowledge
106	106	and expertise.
107	107	Sec. 38.455. REPORT. Not later than the 60th day after the
108	108	date the analysis program receives a request under Section 38.453,
109	109	or, if the analysis program receives a request under that section
110	110	during a regular legislative session, not later than the 45th day
111	111	after the date the analysis program receives the request, the
112	112	center shall prepare a written report containing the results of the
113	113	analysis performed under Section 38.454 and:
114	114	(1) deliver the report to the lieutenant governor, the
115	115	speaker of the house of representatives, and the appropriate
116	116	committees in each house of the legislature; and
117	117	(2) make the report available on a generally
118	118	accessible Internet website.
119	119	Sec. 38.456. FUNDING OF ANALYSIS PROGRAM; FEE. (a) The
120	120	comptroller shall assess an annual fee on each health benefit plan
121	121	issuer that is not operating solely as a Medicaid managed care
122	122	organization in the amount necessary to implement this subchapter.
123	123	(b) The comptroller shall, in consultation with the center:
124	124	(1) determine the amount of the fee assessed under
125	125	this section; and
126	126	(2) adjust the amount of the fee assessed under this
127	127	section for each state fiscal biennium to address any:
128	128	(A) estimated increase in costs to implement this
129	129	subchapter; or
130	130	(B) deficits incurred during the preceding year
131	131	as a result of implementing this subchapter.
132	132	(c) Not later than August 1 of each year, a health benefit
133	133	plan issuer shall pay the fee assessed under this section to the
134	134	comptroller. The legislature may appropriate money received under
135	135	this section only to the center to be used by the center to
136	136	administer the center's duties under this subchapter.
137	137	(d) The comptroller shall adopt rules to administer this
138	138	section.
139	139	Sec. 38.457. DATA CALL ON ADMINISTRATIVE EXPENSES. (a) Not
140	140	later than the 30th day after the date the commissioner receives a
141	141	request from the center, the commissioner shall issue a special
142	142	data call for an estimate of administrative expenses related to
143	143	specific legislation analyzed by the analysis program.
144	144	(b) The commissioner shall provide the special data call
145	145	issued under this section to only the five largest health benefit
146	146	plan issuers affected by the legislation subject to the data call
147	147	under Subsection (a), as measured by a health benefit plan issuer's
148	148	total number of enrollees.
149	149	(c) A response to the special data call issued under this
150	150	section is not subject to disclosure under Chapter 552, Government
151	151	Code.
152	152	(d) A report prepared by the center under this subchapter
153	153	may not disclose a health benefit plan issuer's individual response
154	154	to a data call under this section.
155	155	SECTION 2. (a) As soon as practicable after the effective
156	156	date of this Act, the Center for Health Care Data at The University
157	157	of Texas Health Science Center at Houston shall develop a cost
158	158	estimate of the amount necessary to fund the actual and necessary
159	159	expenses of implementing Subchapter J, Chapter 38, Insurance Code,
160	160	as added by this Act, for the first state fiscal biennium in which
161	161	the Health Impact, Cost, and Coverage Analysis Program will operate
162	162	under that subchapter.
163	163	(b) Not later than January 1, 2026, the Center for Health
164	164	Care Data at The University of Texas Health Science Center at
165	165	Houston shall establish the Health Impact, Cost, and Coverage
166	166	Analysis Program as required by Section 38.452, Insurance Code, as
167	167	added by this Act.
168	168	SECTION 3. Not later than January 1, 2026, the comptroller
169	169	of public accounts shall adopt rules as required by Section 38.456,
170	170	Insurance Code, as added by this Act.
171	171	SECTION 4. This Act takes effect immediately if it receives
172	172	a vote of two-thirds of all the members elected to each house, as
173	173	provided by Section 39, Article III, Texas Constitution. If this
174	174	Act does not receive the vote necessary for immediate effect, this
175	175	Act takes effect September 1, 2025.