Relating to prohibited steering or directing use of certain facilities for emergency care under certain health benefit plans.
Impact
The changes implemented by SB2267 will primarily affect Medicaid managed care organizations and other entities that offer health benefit plans. By preventing these organizations from steering enrollees to particular facilities, the bill aims to create a more equitable environment for patients seeking emergency care. This legislation will take effect on September 1, 2025, with provisions that apply to health benefit plans issued or renewed on or after January 1, 2026. Furthermore, any prior laws governing these matters will remain effective for plans renewed before that date.
Summary
SB2267 seeks to prohibit steering or directing individuals to specific facilities for emergency care within certain health benefit plans. This legislation aims to ensure that enrollees have the freedom to choose where to seek emergency medical services without being influenced by insurers or managed care organizations. The bill defines improperly steering patients as an unfair method of competition or deceptive practice in the insurance industry. By establishing this prohibition, SB2267 seeks to enhance patient autonomy and trust in emergency care decision-making.
Contention
Discussions surrounding SB2267 indicate potential concerns about the practicality of enforcing such prohibitions. Critics may raise issues regarding how to effectively monitor compliance among various health organizations to prevent steering practices. Additionally, there might be apprehension about whether the bill adequately addresses the complex dynamics between insurers, health maintenance organizations, and healthcare providers. It will be crucial to observe how this legislation impacts the wider health care system and whether it leads to significant changes in patient experiences during emergency situations.
Texas Constitutional Statutes Affected
Government Code
Chapter 540. Medicaid Managed Care Program
Section: New Section
Insurance Code
Chapter 541. Unfair Methods Of Competition And Unfair Or Deceptive Acts Or Practices