Texas 2025 - 89th Regular

Texas House Bill HB2150

Voted on by House
 
Out of Senate Committee
 
Voted on by Senate
 
Governor Action
 
Bill Becomes Law
 

Caption

Relating to telephone access for certain health benefit plan verifications and preauthorization requests and for utilization review requests.

Impact

The amendments introduced by HB2150 will significantly impact existing regulations within the Insurance Code. By ensuring that health plans have personnel available at all times, it aims to streamline the verification process. This is particularly relevant for patients who rely on timely authorizations for medical services, which can often lead to delays in necessary treatments. The expectation is that these changes will ultimately lead to improvements in health care outcomes by reducing the time patients spend in waiting for essential services.

Summary

House Bill 2150 seeks to enhance the accessibility of telephone communication for health benefit plan verifications, preauthorization requests, and utilization review requests. The primary objective of this legislation is to mandate that health maintenance organizations (HMOs) and insurers provide 24/7 access to appropriate personnel via a toll-free number. This change is aimed at ensuring that individuals seeking essential health care verifications can do so without delay, ideally enhancing overall patient experience and care coordination.

Contention

While the bill holds the promise of improving access to health care services, it may also face challenges concerning implementation and operational costs for health organizations. Some stakeholders might express concerns regarding the feasibility of maintaining round-the-clock personnel availability, as it could lead to increased operational expenses. Moreover, the ability of HMOs to respond to calls within specified time frames could be scrutinized, particularly if they encounter high volumes of requests that surpass their capacity to respond promptly.

Texas Constitutional Statutes Affected

Insurance Code

  • Chapter 843. Health Maintenance Organizations
    • Section: 347
    • Section: 348
  • Chapter 1301. Preferred Provider Benefit Plans
    • Section: 133
    • Section: 135
  • Chapter 4201. Utilization Review Agents
    • Section: 004

Companion Bills

TX SB177

Identical Relating to telephone access for certain health benefit plan verifications and preauthorization requests and for utilization review requests.

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