Texas House Bill HB2641

Texas 2025 - 89th Regular

• Filed: 2/11/25

Caption

Relating to health benefit plan preauthorization requirements for physicians and providers providing certain health care services.

Impact

Should HB2641 be enacted, the bill would significantly amend the Insurance Code, introducing provisions that protect healthcare providers from being denied payment for services that do not require preauthorization. This change is expected to enhance timely access to necessary medical services for patients, particularly those with chronic conditions or requiring urgent care. Additionally, the bill establishes that approved preauthorization requests will not expire unless treatment standards change, further ensuring that patients receive continuous care without additional hurdles.

Summary

House Bill 2641 aims to regulate preauthorization requirements for health benefit plans specifically targeting a range of healthcare services provided by physicians and other healthcare providers. The proposed legislation seeks to prohibit health maintenance organizations and insurers from requiring preauthorization for critical healthcare services, which include emergency care, primary care, outpatient mental health treatment, and treatment for chronic health conditions. The goal is to streamline the provision of these essential healthcare services and reduce unnecessary bureaucracy that could delay patient care.

Contention

While supporters of HB2641 argue that simplifying preauthorization will improve patient outcomes and reduce administrative burdens on providers, there may be contentions centered around the financial implications for insurers. Critics could argue that removing preauthorization for certain services might lead to increased costs due to potential overutilization. Therefore, discussions around balancing the need for timely healthcare access with cost containment for insurance providers are likely to emerge during the legislative process.

Texas Constitutional Statutes Affected

Insurance Code

• Chapter 4201. Utilization Review Agents
  • Section: New Section