BILL ANALYSIS

H.B. 1428

By: Smithee

Insurance

Committee Report (Unamended)

BACKGROUND AND PURPOSE

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.

CRIMINAL JUSTICE IMPACT

It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.

ANALYSIS

H.B. 1428 amends the Insurance Code to make statutory provisions relating to out-of-network claim dispute resolution applicable to an administrator of a health benefit plan, other than a health maintenance organization plan, under the Texas Public School Retired Employees Group Benefits Act and the Texas School Employees Uniform Group Health Coverage Act. The bill's provisions apply only to a health benefit claim for a medical service or supply provided on or after January 1, 2018.

EFFECTIVE DATE

September 1, 2017.