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Relating to the regulation of utilization review, independent review, and peer
review for health benefit plan and workers' compensation coverage.
No significant fiscal implication to the State is anticipated.
HB 2387 would allow for the peer review of health plans by expanding the definition of "provider of record." In the event of a change in the treatment plan of a patient, a physician of similar specialty would be allowed to authorize the new order and negotiate with the healthcare provider. The bill clarifies that the physician of similar specialty must hold an up to date license.
In the event of an adverse determination by a physician, the bill would allow for the opportunity to discuss the new treatment with the patient by any physician working on the claim. In addition to the changes above, the bill outlines instances for worker's compensation claims and compliance of license requirements with respect to providing for the claims.
HB 2387 provides clarification that the delegation of the review does not remove the responsibility of the agent from complying with standards. Finally, the bill would amend the Occupations Code to establish that a person practicing medicine under these conditions is subject to all regulations of the Texas Medical Board.
Texas Action supports HB 2387 as it uplifts our principles of limited government and personal responsibility. This bill would effectively reduce occupational burdens and give physicians more time to treat patients, by reducing the time spent on overly burdensome paperwork. By allowing practicing physicians to delegate the review of certain claims, this would help create a more efficient work environment in a heavily regulated field.