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 | |
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| 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. | ||
