BILL ANALYSIS

Senate Research Center	H.B. 1428
85R7849 LED-D	By: Smithee (Huffman)
	State Affairs
	5/5/2017
	Engrossed

AUTHOR'S / SPONSOR'S STATEMENT OF INTENT

Interested parties report that the out-of-network claim dispute resolution process available to certain health benefit plan enrollees has led to both fair resolution of claims and cost savings for enrollees. H.B. 1428 seeks to provide that dispute resolution process to enrollees in the Texas Public School Employees Group Benefits Program and the uniform group coverage program established under the Texas School Employees Uniform Group Health Coverage Act.

H.B. 1428 amends current law relating to mediation of the settlement of certain out-of-network health benefit claims involving balance billing for members of the Teacher Retirement System of Texas.

RULEMAKING AUTHORITY

This bill does not expressly grant any additional rulemaking authority to a state officer, institution, or agency.

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Sections 1467.001(1) and (3), Insurance Code, as follows:

(1) Redefines "administrator" to include an administering firm for a health benefit plan under Chapter 1551 (Texas Employees Group Benefits Act), 1575 (Texas Public School Employees Group Benefits Program), or 1579 (Texas School Employees Uniform Group Health Coverage), rather than a health benefit plan providing coverage under Chapter 1551.

(3) Redefines "enrollee" to make a conforming change.

SECTION 2. Amends Section 1467.002, Insurance Code, to make a conforming change.

SECTION 3. Makes application of this Act prospective to January 1, 2018.

SECTION 4. Effective date: September 1, 2017.