|
|
|
A BILL TO BE ENTITLED
|
|
AN ACT
|
|
relating to an interim house study regarding retrospective denial |
|
by health benefit plans of health benefit claims for emergency |
|
care. |
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
SECTION 1. HOUSE COMMITTEE. (a) A standing committee of |
|
the house of representatives shall study and report to the speaker |
|
and members of the house of representatives regarding the practice |
|
of retrospective denial by health benefit plans of health benefit |
|
claims for emergency care. |
|
(b) Not later than the 60th day after the effective date of |
|
this Act, the speaker of the house of representatives shall appoint |
|
an appropriate committee from the standing committees of the house |
|
of representatives to conduct the study and prepare the report |
|
required by Subsection (a) of this section. |
|
SECTION 2. STUDY. The committee selected under Section 1 of |
|
this Act shall, with respect to the practice of retrospective |
|
denial by health benefit plans of health benefit claims for |
|
emergency care, study: |
|
(1) the formal and informal policies of health benefit |
|
plans under which claims for emergency care are denied after the |
|
care has been provided to a covered person; |
|
(2) the effect the retrospective denial practice has |
|
on whether residents of this state seek emergency care; |
|
(3) patient expectations about health benefits that |
|
may be available when seeking emergency care; |
|
(4) the conflict between the application of the |
|
retrospective denial practice and the prudent layperson standard |
|
adopted in this state with respect to emergency care; and |
|
(5) the effect the retrospective denial practice has |
|
on medical debt incurred by residents of this state. |
|
SECTION 3. REPORT. Not later than January 1, 2021, the |
|
committee selected under Section 1 of this Act shall report the |
|
committee's findings and recommendations to the speaker and members |
|
of the house of representatives. The committee shall include in the |
|
recommendations specific statutory changes, including any changes |
|
necessary to Title 8, Insurance Code, that may appear necessary or |
|
advisable from the committee's study conducted under Section 2 of |
|
this Act. |
|
SECTION 4. EXPIRATION. This Act expires September 1, 2021. |
|
SECTION 5. EFFECTIVE DATE. This Act takes effect September |
|
1, 2019. |