Bill Text: TX HB2403 | 2023-2024 | 88th Legislature | Introduced


Bill Title: Relating to the establishment of the Texas Health Insurance Mandate Advisory Review Center; authorizing a fee.

Spectrum: Partisan Bill (Republican 7-0)

Status: (Introduced - Dead) 2023-03-13 - Referred to State Affairs [HB2403 Detail]

Download: Texas-2023-HB2403-Introduced.html
  88R6515 RDS-F
 
  By: Paul H.B. No. 2403
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the establishment of the Texas Health Insurance Mandate
  Advisory Review Center; authorizing a fee.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Chapter 38, Insurance Code, is amended by adding
  Subchapter J to read as follows:
  SUBCHAPTER J. TEXAS HEALTH INSURANCE MANDATE ADVISORY REVIEW CENTER
         Sec. 38.451.  DEFINITIONS. In this subchapter:
               (1)  "Enrollee" means an individual who is enrolled in
  a health benefit plan, including a covered dependent.
               (2)  "Health benefit plan issuer" means an insurer,
  health maintenance organization, or other entity authorized to
  provide health benefits coverage under the laws of this state,
  including a Medicaid managed care organization.
               (3)  "Health care provider" means a physician,
  facility, or other person who is licensed, certified, registered,
  or otherwise authorized to provide a health care service in this
  state.
               (4)  "Health care service" means a service, procedure,
  drug, or device to diagnose, prevent, alleviate, cure, or heal a
  human disease, injury, or unhealthy or abnormal physical or mental
  condition, including a service, procedure, drug, or device related
  to pregnancy or delivery.
               (5)  "Mandate" means a provision of a bill or joint
  resolution that requires a health benefit plan issuer to:
                     (A)  provide coverage for a health care service;
                     (B)  increase or decrease payments to health care
  providers for a health care service; or
                     (C)  implement a new contractual or
  administrative requirement.
               (6)  "Mandate review center" means the Texas Health
  Insurance Mandate Advisory Review Center established under Section
  38.452.
         Sec. 38.452.  ESTABLISHMENT OF MANDATE REVIEW CENTER. The
  Center for Healthcare Data at The University of Texas Health
  Science Center at Houston shall establish the Texas Health
  Insurance Mandate Advisory Review Center to prepare analyses of
  bills and joint resolutions that would impose new mandates on
  health benefit plan issuers in this state.
         Sec. 38.453.  REQUEST FOR ANALYSIS OF MANDATE. (a)  
  Regardless of whether the legislature is in session, the lieutenant
  governor, the speaker of the house of representatives, or the chair
  of the appropriate committee in either house of the legislature may
  submit a request to the mandate review center to prepare and develop
  an analysis of a proposed or enacted bill or joint resolution that
  imposes a new mandate on health benefit plan issuers in this state.
         (b)  A request submitted under this section must include a
  draft of the bill or joint resolution prepared by the Texas
  Legislative Council or a copy of an act of the Texas Legislature.
         Sec. 38.454.  ANALYSIS OF MANDATE. (a)  On receiving a
  request under Section 38.453, the mandate review center shall
  conduct an analysis of, as applicable, the extent to which:
               (1)  the mandate has increased or decreased or is
  expected to increase or decrease total spending in this state for
  any relevant health care service, including the estimated dollar
  amount of that increase or decrease;
               (2)  the mandate has increased or is expected to
  increase the utilization of any relevant health care service in
  this state;
               (3)  the mandate has increased or decreased or is
  expected to increase or decrease administrative expenses of health
  benefit plan issuers and expenses of enrollees, plan sponsors, and
  policyholders;
               (4)  the mandate has increased or decreased or is
  expected to increase or decrease the total spending by all persons
  in the private sector, by public sector entities, including state
  or local retirement systems and political subdivisions, and
  individuals purchasing individual health insurance or health
  benefit plan coverage in this state;
               (5)  coverage for any relevant health care service is
  or was, without the mandate, generally available or utilized; or
               (6)  any relevant health care service is supported by
  medical and scientific evidence, including:
                     (A)  determinations made by the United States Food
  and Drug Administration;
                     (B)  coverage determinations made by the Centers
  for Medicare and Medicaid Services;
                     (C)  determinations made by the United States
  Preventive Services Task Force; and
                     (D)  nationally recognized clinical practice
  guidelines.
         (b)  In conducting an analysis under this section, the
  mandate review center may consult with persons with relevant
  knowledge and expertise.
         Sec. 38.455.  REPORT. Not later than 60 days after receiving
  a request under Section 38.453, the mandate review center shall
  prepare a written report containing the results of the analysis
  performed under Section 38.454 and:
               (1)  deliver the report to the lieutenant governor, the
  speaker of the house of representatives, and the appropriate
  committees in each house of the legislature; and
               (2)  make the report available on a generally
  accessible Internet website.
         Sec. 38.456.  FUNDING OF MANDATE REVIEW CENTER; FEE.  (a)  
  The department shall assess an annual fee on each health benefit
  plan issuer other than an issuer operating solely as a Medicaid
  managed care organization in the amount necessary to implement this
  subchapter.
         (b)  The mandate review center shall develop an annual cost
  estimate of the amount necessary to fund the actual and necessary
  expenses of implementing this subchapter.
         (c)  The department shall, in consultation with the mandate
  review center:
               (1)  determine the amount of the fee assessed under
  this section; and
               (2)  adjust the amount of the fee assessed under this
  section for each state fiscal biennium to address any:
                     (A)  estimated increase in costs to implement this
  subchapter; or
                     (B)  deficits incurred during the preceding year
  as a result of implementing this subchapter.
         (d)  Not later than August 1 of each year, a health benefit
  plan issuer shall pay the fee assessed under this section to the
  department. The legislature may appropriate money received under
  this section only to The University of Texas Health Science Center
  at Houston to be used by the Center for Healthcare Data to
  administer the center's duties under this subchapter.
         (e)  The commissioner shall adopt rules to administer this
  section.
         SECTION 2.  Not later than January 1, 2024, the Center for
  Healthcare Data at The University of Texas Health Science Center at
  Houston shall establish the Texas Health Insurance Mandate Advisory
  Review Center as required by Section 38.452, Insurance Code, as
  added by this Act.
         SECTION 3.  Not later than January 1, 2024, the commissioner
  of insurance shall adopt rules as required by Section 38.456,
  Insurance Code, as added by this Act.
         SECTION 4.  This Act takes effect September 1, 2023.
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