State Updates

New Statutes Effective September 1, 2023

 

On May 23, 2023, Gov. Abbott signed HB 290 into law. This bill allows multiple employer welfare arrangements (MEWAs) based on the employers' geographical association, allows for "working owners" to get MEWA coverage, waives the two-year business existence requirement, and requires demonstration of federal compliance. The bill also authorizes MEWAs to provide comprehensive health benefit plans and structure them like a PPO/EPO, provided the MEWA complies with additional Insurance Code provisions.

On May 29, 2023, Gov. Abbott signed SB 622 into law. This bill requires health plan issuers in the state to list those generic and brand-name prescription drugs covered by a specific health insurance plan, the enrollee's eligibility, cost-sharing information, and applicable utilization management requirements. The bill also specifies that the health benefit plan issuer must respond to requests in real time and cannot restrict a prescribing provider from communicating information about the drug or penalize a provider for disclosing or prescribing lower cost alternative drugs.

On June 12, 2023, Gov. Abbott signed HB 711 into law. This bill prohibits the use of gag clauses, among other things, within network provider contracts. Note that the bill contains provisions that may affect its effective date. The Department of Insurance will promulgate rules to administer and enforce this bill.

On June 12, 2023, Gov. Abbott signed HB 1592 into law. This bill allows self-insured plans to opt into the state’s surprise billing and related independent dispute resolution process. 

On June 18, 2023, Gov. Abbott signed SB 2476 into law. This bill adds ground ambulance services to those services subject to the state’s surprise billing law. However, this service will not be covered by the state’s independent dispute resolution process. Instead, the Department of Insurance will develop a billing rate database and promulgate rules that require health plans to reimburse ground ambulance services at either of the following:

  • A rate set, controlled, or regulated by a political subdivision if the entity has submitted the rate to the Texas Department of Insurance database (with an annual increase per Medicare Inflation Index, not to exceed 10%).
  • The lesser of the billed charge or 325% of Medicare.

HB 290 »
SB 622 »
HB 711 »
HB 1592 »
SB 2476 »

PPI Benefit Solutions does not provide legal or tax advice. Compliance, regulatory and related content is for general informational purposes and is not guaranteed to be accurate or complete. You should consult an attorney or tax professional regarding the application or potential implications of laws, regulations or policies to your specific circumstances.

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