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2023 TEXAS LEGISLATIVE
SESSION WRAP-UP

Navigating New Health Insurance Laws

In Texas: What You Need To Know

By Ezequiel “Zeke” Silva III, MD

Key Points countable to physicians, employers and patients by: (1) restricting
• The 88th Texas legislative regular session brought both some wins network adequacy waivers to those with valid reasons; (2) ensuring
and some draws for the healthcare sector regarding insurance. robust networks through specific time, distance and physician spe-
• Wins for patients and physicians related to health insurance in- cialty criteria; and (3) limiting unfavorable changes during the con-
cluded: (1) strengthening network adequacy requirements through tract period.
legislation; and (2) the non-passage of numerous unfavorable insur- • Insurance Steerage (HB 2414): This bill, which failed to pass,
ance bills (including insurance steerage legislation and legislation aimed to grant health plans the ability to direct and incentivize pa-
that would have enabled carriers to offer health plans that carved tients to see specific physicians, providers, pharmacies and hospitals.
out numerous critical patient and physician statutory protections, The Texas Medical Association's (TMA) grassroots efforts played a
such as prompt pay law and network adequacy requirements). crucial role in preventing its passage.
• An insurance-related draw was the non-passage of favorable legis- • Physician Ranking and Tiering (HB 3351): This bill, which failed
lation aiming to enhance limits on prior authorization, following to pass, would have undone landmark physician and patient protec-
Texas’ gold carding law (HB 3459) from the previous session. tions when it comes to health plans’ physician ranking programs.
• Consumer Choice of Benefit Plan Carveouts (HB 1001): This
What you need to know: bill, which failed to pass, would have allowed consumer choice of
• Network Adequacy (HB 3359): A newly passed law that bolsters benefit plans to be offered that were exempt from the application
existing network adequacy requirements. It holds health plans ac- of numerous non-benefit-related patient and provider Texas law

28 SAN ANTONIO MEDICINE • August 2023