Texas 2025 - 89th Regular

Texas Senate Bill SB2012 Compare Versions

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

Old	New	Differences
1	1	89R5925 DNC-F
2	2	By: Campbell S.B. No. 2012
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7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to the provision of certain information about physicians
10	10	and nurses making determinations regarding requests for
11	11	preauthorization of health care services or supplies.
12	12	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
13	13	SECTION 1. Subchapter G, Chapter 4201, Insurance Code, is
14	14	amended by adding Section 4201.3025 to read as follows:
15	15	Sec. 4201.3025. PREAUTHORIZATION DETERMINATION: REQUIRED
16	16	PHYSICIAN INFORMATION. A utilization review agent shall include in
17	17	any written documentation that records a utilization review
18	18	determination made regarding a request for preauthorization, as
19	19	defined by Section 4201.651, or a determination made in an appeal of
20	20	an adverse determination made regarding a request for
21	21	preauthorization:
22	22	(1) the signature of the physician or nurse making the
23	23	determination;
24	24	(2) the full printed name of the physician or nurse;
25	25	(3) a unique provider identifier number for the
26	26	physician or nurse, such as a national provider identifier;
27	27	(4) the credentials of the physician or nurse,
28	28	including board certification and area of specialty expertise and
29	29	training, as applicable;
30	30	(5) attestation by the physician or nurse that the
31	31	physician or nurse has appropriate training and expertise in the
32	32	field of medicine that is sufficient to make an informed decision
33	33	regarding the medical necessity or appropriateness of the health
34	34	care service or supply proposed to be provided to the patient;
35	35	(6) attestation by the physician or nurse that the
36	36	physician or nurse does not have a conflict of interest that would
37	37	interfere with the physician's or nurse's ability to make an
38	38	impartial determination based on the merits of the specific patient
39	39	case; and
40	40	(7) the amount of time the physician or nurse spent
41	41	evaluating medical records or other information related to the
42	42	review or appeal before making the determination.
43	43	SECTION 2. Section 4201.3025, Insurance Code, as added by
44	44	this Act, applies only to a request for preauthorization made on or
45	45	after January 1, 2026, under a health benefit plan delivered,
46	46	issued for delivery, or renewed on or after that date.
47	47	SECTION 3. This Act takes effect September 1, 2025.