BILL ANALYSIS

Senate Research Center	H.B. 1942
89R5965 SCF-D	By: Smithee (Perry)
	Health & Human Services
	5/20/2025
	Engrossed

AUTHOR'S / SPONSOR'S STATEMENT OF INTENT

The number of individuals seeking coverage from individual and small group health insurance plans and the health insurance marketplace has grown significantly in recent years, now covering 5.5 million Texans. As coverage grows, however, so does the strain on health insurance provider networks. Texas currently has one of the worst primary care provider shortages in the nation, ranking 48th in the supply of primary care providers.

One of the barriers contributing to this problem are requirements related to healthcare provider enrollment. Currently under Texas law, advanced practice registered nurses (APRNs), such as nurse practitioners, may only serve as primary care providers for certain health insurance plans regulated by the Texas Department of Insurance if the APRN's delegating physician also participates in that health insurance plan. This requirement decreases the number of available providers participating in a health plan's network and ultimately reduces access to care for Texas patients, especially in rural and underserved areas of the state.

In 2017, the legislature attempted to address the critical lack of primary care providers with passage of S.B. 654, which eliminated the requirement that APRNs only accept a Medicaid insurance plan if their delegating physician also accepts that plan. The bill passed with broad stakeholder support from the Texas Association of Health Plans, the Texas Medical Association, Texas Nurse Practitioners, and other groups, and has been in effect for eight years.

S.B. 654 originally included Medicaid and commercial plans, but commercial plans were left out of the final version of the bill. H.B. 1942 is clean-up legislation that seeks to extend the same flexibilities afforded to Medicaid plans to all state-regulated health plans. Allowing health plans to utilize APRNs, regardless of whether their delegating physician wants to accept the same health plan, is a tested, commonsense solution that will increase flexibility for health plans and expand primary care access in Texas.

H.B. 1942 amends current law relating to the participation of an advanced practice registered nurse as a participating or preferred provider for health maintenance organizations and preferred provider benefit plans.

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 Subchapter I, Chapter 843, Insurance Code, by adding Section 843.3125, as follows:

Sec. 843.3125. CONTRACTS WITH ADVANCED PRACTICE REGISTERED NURSES.� (a)� Authorizes a health maintenance organization to contract directly with an advanced practice registered nurse to provide health care services on behalf of the health maintenance organization regardless of whether the physician supervising the advanced practice registered nurse provides health care services for the health maintenance organization.

(b) Prohibits this section from being construed as authorizing a health maintenance organization to supervise or control the practice of medicine as prohibited by Subtitle B (Physicians), Title 3 (Health Professions), Occupations Code.

SECTION 2. Amends Subchapter B, Chapter 1301, Insurance Code, by adding Section 1301.0525, as follows:

Sec. 1301.0525. DESIGNATION OF ADVANCED PRACTICE REGISTERED NURSES AS PREFERRED PROVIDERS. (a) Authorizes an insurer offering a preferred provider benefit plan to designate an advanced practice registered nurse as a preferred provider regardless of whether the physician supervising the advanced practice registered nurse is a preferred provider.

(b) Prohibits this section from being construed as authorizing an insurer to supervise or control the practice of medicine as prohibited by Subtitle B, Title 3, Occupations Code.

SECTION 3.� Effective date: September 1, 2025.