Bill > SB1742

This bill makes several key changes to physician and health care provider directories, preauthorization requirements, and utilization, independent, and peer review processes for certain health benefit plans and workers' compensation coverage in Texas: - It defines new terms like "facility-based physician" and expands requirements for health benefit plan provider directories to include more detailed information about facility-based physicians and the health plans that cover their services. - It requires health maintenance organizations and insurers that use preauthorization to post their preauthorization requirements and processes online, provide advance notice of changes, and offer expedited appeals for violations. - It clarifies requirements for utilization review, independent review, and peer review to be conducted by physicians licensed in Texas and of the same or similar specialty as the provider ordering the services under review. - It creates a joint interim legislative committee to study and propose reforms related to the transparency and patient outcomes of prior authorization and utilization review processes used by private health benefit plan issuers in Texas. The bill's provisions generally take effect on September 1, 2019, with some transition periods for certain requirements.

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https://capitol.texas.gov/BillLookup/History.aspx?LegSess=86R&Bill=SB1742