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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
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