Bill Text: TX SB1135 | 2021-2022 | 87th Legislature | Introduced
Bill Title: Relating to the establishment of a statewide all payor claims database to store publicly accessible information.
Spectrum: Partisan Bill (Republican 2-0)
Status: (Introduced - Dead) 2021-03-23 - Co-author authorized [SB1135 Detail]
Download: Texas-2021-SB1135-Introduced.html
87R3078 JG-D | ||
By: Kolkhorst | S.B. No. 1135 |
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relating to the establishment of a statewide all payor claims | ||
database to store publicly accessible information. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subtitle E, Title 2, Health and Safety Code, is | ||
amended by adding Chapter 108A to read as follows: | ||
CHAPTER 108A. STATEWIDE ALL PAYOR CLAIMS DATABASE | ||
Sec. 108A.001. DEFINITIONS. In this chapter: | ||
(1) "Center" means the Center for Healthcare Data at | ||
The University of Texas Health Science Center at Houston. | ||
(2) "Database" means the statewide all payor claims | ||
database established under this chapter. | ||
(3) "Payor" means an insurance company, a health | ||
maintenance organization, a Medicaid managed care organization, or | ||
another organization that pays a health care provider to provide | ||
health care benefits to a patient. | ||
Sec. 108A.002. ESTABLISHMENT AND ADMINISTRATION OF | ||
STATEWIDE ALL PAYOR CLAIMS DATABASE. (a) The department shall | ||
collaborate with and leverage the existing resources and | ||
infrastructure of the center to establish a statewide all payor | ||
claims database to collect, process, and store health care claims | ||
information. | ||
(b) The center shall serve as the administrator of the | ||
database and manage information submitted for inclusion in the | ||
database. In determining the information a payor is required to | ||
submit to the center, the center must consider requiring inclusion | ||
of information useful to researchers and policymakers for improving | ||
health care quality and outcomes and lowering health care costs and | ||
information useful to consumers for price transparency. The | ||
required information at a minimum must include: | ||
(1) the name of the health care provider paid by the | ||
payor; | ||
(2) the type of health care benefits provided by the | ||
health care provider; | ||
(3) the amount paid by the payor for the health care | ||
benefits; and | ||
(4) the estimated copayment amount paid by the patient | ||
who received the health care benefits. | ||
(c) Each payor annually shall submit to the center for | ||
inclusion in the database the health care claims information | ||
required by the center under Subsection (b) for all health care | ||
benefits paid by the payor during the preceding year. | ||
(d) The center shall ensure that health care claims | ||
information submitted to the center under Subsection (c) is stored | ||
in the database and accessible to the public in the manner described | ||
by Section 108A.003. | ||
Sec. 108A.003. PUBLIC ACCESS TO DATABASE. (a) The center | ||
shall aggregate information submitted to or stored in the database | ||
in an open-source format that is machine-readable and allows the | ||
public to easily access and navigate the information. | ||
(b) The database must be accessible through the center's | ||
Internet website and allow the public to search the information in | ||
the database at a minimum by the categories described by Section | ||
108A.002(b). | ||
(c) The center shall ensure information in the database that | ||
is accessible to the public does not disclose a patient's | ||
personally identifiable information or information that is | ||
confidential under state or federal law. | ||
Sec. 108A.004. MEMORANDUM OF UNDERSTANDING; RULES. The | ||
executive commissioner on behalf of the department, the Texas | ||
Higher Education Coordinating Board on behalf of the center, and | ||
the commissioner of insurance on behalf of the Texas Department of | ||
Insurance shall each by rule adopt a memorandum of understanding | ||
that: | ||
(1) ensures the database is operated and maintained in | ||
accordance with this chapter; | ||
(2) as applicable, defines each agency's | ||
responsibilities with respect to payors that are: | ||
(A) required to submit health care claims | ||
information to the database; and | ||
(B) under the jurisdiction of the agency; and | ||
(3) identifies and establishes enforcement mechanisms | ||
for each agency to ensure: | ||
(A) the center, in collaboration with the | ||
department, operates and maintains the database in accordance with | ||
this chapter; and | ||
(B) payors under the jurisdiction of the agency | ||
submit the required health care claims information to the database | ||
in accordance with this chapter. | ||
SECTION 2. As soon as practicable after the effective date | ||
of this Act, the executive commissioner of the Health and Human | ||
Services Commission, the Texas Higher Education Coordinating | ||
Board, and the commissioner of insurance shall adopt rules | ||
necessary to implement Chapter 108A, Health and Safety Code, as | ||
added by this Act. | ||
SECTION 3. If before implementing any provision of this Act | ||
a state agency determines that a waiver or authorization from a | ||
federal agency is necessary for implementation of that provision, | ||
the agency affected by the provision shall request the waiver or | ||
authorization and may delay implementing that provision until the | ||
waiver or authorization is granted. | ||
SECTION 4. This Act takes effect September 1, 2021. |