Bill: HB 2151, 86(R) - 2019

Committee

House Insurance

Vote Recommendation

Vote Recommendation Economic Freedom Property Rights Personal Responsibility Limited Government Individual Liberty
No Negative Neutral Neutral Negative Neutral

Author(s)

Sergio Munoz Jr.

Bill Caption

Relating to the use of extrapolation by a health maintenance organization or an insurer to audit claims.

Fiscal Notes

According to the Legislative Budget Board, no fiscal impact to the state is anticipated. 

Bill Analysis

HB 2151 would amend the Insurance Code to prohibit a health maintenance organization or insurer from using extrapolation, an estimate of audit results for a large group of claims not reviewed by the insurance organization, to complete an audit of participating physicians or providers. Any additional payment due to a physician or provider or any refund due to the health maintenance organization or insurer must be based on actual overpayment or underpayment and may not be based on extrapolation.

Vote Recommendation Notes

This bill violates our free market and limited government principles by prohibiting an audit practice by private insurance organizations. It is not a proper role of government to regulate auditing practices of a voluntary agreement for services between insurance organizations and participating providers. For these reasons, we oppose HB 2151.
Source URL (retrieved on 05/10/2025 03:05 AM): http://reports.texasaction.com/bill/86r/hb2151?print_view=true