Bill > SB742

This bill expands the responsibilities and authorities of the Office of Public Insurance Counsel (OPIC) in monitoring and evaluating managed care plans in Texas. The bill broadens the definition of "health benefit plan" to include preferred provider and exclusive provider benefit plans, and defines "managed care plan" to encompass health maintenance organizations, preferred provider plans, and exclusive provider benefit plans. OPIC will now be empowered to monitor network adequacy by reviewing filings, applications, and requests related to access plans and network adequacy waivers. The office can advocate for consumers by highlighting network inadequacies and can appear in proceedings involving a managed care plan's ability to provide accessible healthcare services. The bill also requires OPIC to develop a system to compare and evaluate managed care plans objectively, with annual consumer report cards that compare plans within the same type (e.g., health maintenance organizations to other health maintenance organizations). The office will have expanded access to information, including all filings and regulatory correspondence related to network adequacy. These changes aim to strengthen consumer protections and provide more transparency in the managed care plan landscape, with the legislative intent of allowing OPIC flexibility in implementing these new requirements. The bill is set to take effect on September 1, 2025.

Health and Social Services

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=SB742