Bill Text: TX SB1149 | 2023-2024 | 88th Legislature | Introduced
Bill Title: Relating to telephone access for certain health benefit plan verifications and preauthorization requests and for utilization review requests.
Spectrum: Slight Partisan Bill (Republican 2-1)
Status: (Introduced - Dead) 2023-03-09 - Referred to Health & Human Services [SB1149 Detail]
Download: Texas-2023-SB1149-Introduced.html
88R446 RDS-F | ||
By: Menéndez | S.B. No. 1149 |
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relating to telephone access for certain health benefit plan | ||
verifications and preauthorization requests and for utilization | ||
review requests. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 843.347(c), Insurance Code, is amended | ||
to read as follows: | ||
(c) A health maintenance organization shall have | ||
appropriate personnel reasonably available at a toll-free | ||
telephone number to provide a verification under this section 24 | ||
hours a day, seven days a week, including [ |
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must: | ||
(1) have a telephone system capable of accepting or | ||
recording incoming phone calls for verifications during any period | ||
in which personnel are not available due to circumstances beyond | ||
the health maintenance organization's reasonable control; [ |
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(2) respond [ |
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soon as possible but not later than two hours after [ |
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SECTION 2. Section 843.348(f), Insurance Code, is amended | ||
to read as follows: | ||
(f) A health maintenance organization shall have | ||
appropriate personnel reasonably available at a toll-free | ||
telephone number to respond to requests for a preauthorization 24 | ||
hours a day, seven days a week, including [ |
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must: | ||
(1) have a telephone system capable of accepting or | ||
recording incoming phone calls for preauthorizations during any | ||
period in which personnel are not available due to circumstances | ||
beyond the health maintenance organization's reasonable control; | ||
[ |
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(2) respond [ |
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soon as possible but not later than two [ |
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received. | ||
SECTION 3. Section 1301.133(c), Insurance Code, is amended | ||
to read as follows: | ||
(c) An insurer shall have appropriate personnel reasonably | ||
available at a toll-free telephone number to provide a verification | ||
under this section 24 hours a day, seven days a week, including | ||
[ |
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must: | ||
(1) have a telephone system capable of accepting or | ||
recording incoming phone calls for verifications during any period | ||
in which personnel are not available due to circumstances beyond | ||
the insurer's reasonable control; [ |
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(2) respond [ |
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soon as possible but not later than two hours after [ |
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SECTION 4. Section 1301.135(e), Insurance Code, is amended | ||
to read as follows: | ||
(e) An insurer shall have appropriate personnel reasonably | ||
available at a toll-free telephone number to respond to requests | ||
for a preauthorization 24 hours a day, seven days a week, including | ||
[ |
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must: | ||
(1) have a telephone system capable of accepting or | ||
recording incoming phone calls for preauthorizations during any | ||
period in which personnel are not available due to circumstances | ||
beyond the insurer's reasonable control; [ |
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(2) respond [ |
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soon as possible but not later than two [ |
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received. | ||
SECTION 5. Section 4201.004(a), Insurance Code, is amended | ||
to read as follows: | ||
(a) A utilization review agent shall: | ||
(1) have appropriate personnel reasonably available, | ||
by toll-free telephone 24 hours a day, seven days a week, including | ||
legal holidays [ |
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to telephone review requests; | ||
(2) have a telephone system capable, during any period | ||
in which personnel are not available due to circumstances beyond | ||
the utilization review agent's reasonable control [ |
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telephone calls or of providing instructions to a caller; and | ||
(3) respond to a call made during a period described by | ||
Subdivision (2) as soon as possible but [ |
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after the call is received [ |
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[ |
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[ |
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SECTION 6. This Act takes effect September 1, 2023. |