HB 2035 – Texas

Status: Inactive / Dead
Year Introduced: 2021
Link: https://capitol.texas.gov/BillLookup/History.aspx?LegSess=87R&Bill=HB2035

Relating to utilization review of emergency care claims under health benefit plans. The bill would amend the Government Code relating to utilization review of emergency care claims under health benefit plans. The bill requires that the Health and Human Services Commission (HHSC) contracts with Medicaid managed care organizations (MCOs) include a provision that the MCOs must comply with Section 541.062 of the Insurance Code. Further, the bill requires utilization review of emergency care claims to be performed by a board­certified emergency room physician licensed to practice in the state, and places certain new requirements on utilization review. Depending on the level of costs incurred to the MCOs, the managed care capitation rate may need to be adjusted.


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