Bill Caption

Fiscal Notes

No significant fiscal implication to the State is anticipated.

No fiscal implication to units of local government is anticipated.

Bill Analysis

5/26/2015 update:

This bill was amended on the House floor and in the Senate committee. The first and second chamber analyses are below.

First chamber analysis:

The bill would amend Chapters 1369 and 1451 of the Insurance Code.

The bill would require a health benefit plan issuer to publish its formulary information for prescription drugs on the issuer’s website. The Texas Department of Insurance (TDI) would appoint an advisory committee, composed of certain stakeholders, to advise TDI on the development of a template for a health benefit plan issuer to use to display formulary information. The template would have to be electronically searchable by drug name and include each enrollee’s cost-sharing amount or a cost-sharing range, in addition to other required information.

A health benefit plan issuer that offers coverage for health care services through preferred providers, exclusive providers, or a network of physicians or health care providers would be required to develop and maintain a physician and health care provider directory containing contact information for each physician and health care provider. The directory would have to be publicly available on the issuer’s website and be electronically searchable by a physician or health care provider’s name and location.

Second chamber analysis:

The bill would amend Chapters 1369 and 1451 of the Insurance Code.

The bill would require a health benefit plan issuer to publish its formulary information for prescription drugs on the issuer’s website. The formulary disclosures would have to be electronically searchable by drug name and include each enrollee's cost-sharing amount or a cost-sharing range, in addition to other required information. The commissioner by rule would be able to allow an alternative method of making disclosures required under Section 1369.0543 (d) (1) relating to cost-sharing through a web-based tool that would be required to:

1. be publicly accessible to enrollees, prospective enrollees, and others without the necessity of providing a password, user name, or personally identifiable information;
2. allow consumers to electronically search formulary information by the name under which the health benefit plan is marketed; and
3. be accessible through a direct link that is displayed on each page of the formulary disclosure that lists each drug as required under Section 1369.0543 (c).

A health benefit plan issuer that offers coverage for health care services through preferred providers, exclusive providers, or a network of physicians or health care providers would be required to develop and maintain a physician and health care provider directory containing contact information for each physician and health care provider. The directory would have to be publicly available on the issuer’s website and be electronically searchable by a physician or health care provider’s name and location.

Vote Recommendation Notes

5/26/2015 update:

This bill was amended on the House floor and in the Senate committee. We continue to support HB 1624.

The second chamber sponsor is Senator Seliger.

First chamber recommendation below:

The purpose of the legislation is to provide consumers with electronically accessible information regarding health benefit plan coverage. We support HB 1624 because it enhances transparency (in an industry heavily controlled by government mandates and regulations) which would help consumers better understand their health benefit plan coverage options. 

Ultimately, the long term solution to these problems is to largely extract government from the health care and health insurance industries altogether and allow them to operate on a free market basis. However, under the current system this government imposed solution to a government created problem is acceptable.