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3 Document(s) [ Subject: Texas Health Insurance Risk Pool ]

Committee: House Insurance
Title: Interim Report
Subjects: Automobile insurance | Flood insurance | Health insurance | Insurance industry | Insurance, Texas Department of | Medical bill balance billing | Patient Protection and Affordable Care Act | Pharmaceutical industry | Texas Health Insurance Risk Pool | Texas Windstorm Insurance Association |
Library Call Number: L1836.86 In7
Session: 86th R.S. (2019)
Online version: View report [83 pages  File size: 5,196 kb]
Charges: This report should address the charges below.
1. Monitor the agencies and programs under the Committee's jurisdiction and oversee the implementation of relevant legislation passed by the 86th Legislature. Conduct active oversight of all associated rulemaking and other governmental actions taken to ensure intended legislative outcome of all legislation, including the following:
  • HB 259, which prohibits certain practices related to the delivery, issuing of delivery, or renewing of named driver policies. Determine if there are any changes regarding policy affordability or the uninsured motorist population.
  • HB 1900, which amends the Texas Windstorm Insurance Association (TWIA) operations and funding practices. Review the rulemaking process by the Texas Department of Insurance (TDI) and the adoption of an updated plan of operation by TWIA. Monitor whether the purchase of reinsurance has increased or declined and determine whether this provision of the legislation has had any impact on premium rates. Monitor the appointment and work of the Legislative Funding and Funding Structure Oversight board.
  • HB 2536, which requires certain reporting requirements for drug manufacturers, pharmacy benefit managers, and health insurers on certain pharmaceutical practices, including the pricing and availability of insulin. Examine its effect on drug pricing in the market and how to increase transparency in pricing associated with delivery of drugs, such as insulin, to the end user patient.
  • SB 442, which requires insurers that do not provide flood coverage in their policy to disclose that the policy does not cover flood events. Determine whether consumers are being properly informed of whether they have flood coverage. Examine the development of standardized disclosure forms for all insurance policies in Texas (health, homeowners, and personal auto) to provide more clarity to consumers about what the policy covers and any exclusions.
  • SB 1264, which prohibits balance billing (surprise billing) and creates an arbitration system to settle balance bills. Monitor the implementation of the mediation and arbitration programs, including the establishment of a portal on the TDI website through which requests for mediation and arbitration may be submitted. Determine whether the appropriate state agencies are enforcing the prohibition on balance billing. Review the Department's rules implementing the legislation's exception for non-emergency "elective" services to determine whether the rules limit the exception to out-of-network services that a patient has actively elected after receiving a complete written disclosure. Monitor or follow up on TDI's process for selecting the benchmarking database and determine whether the database chosen provides the most accurate available data and its sources are transparent. Evaluate the fiscal impact of the legislation on the Employees Retirement System of Texas and the Teacher Retirement System of Texas. Review costs to the systems and savings to employees and teachers.
  • SB 1852, which requires certain disclosures for insurers that offer short-term limited duration plans. Study whether similar consumer disclosures and other safeguards are needed for non-traditional health coverage products marketed to individuals or small employers in Texas. Identify any gaps that leave consumers without needed information or consumer protections, including network adequacy and protections from surprise medical bills.
  • SB 1940, which extends to August 31, 2021, TDI's authority to revise and administer the temporary health insurance risk pool to the extent federal funds are available. Study ways to foster a competitive market and reduce the uninsured rate, including by exploring flexibility available through federal waivers. Study the impact to health care systems if the Affordable Care Act is ruled unconstitutional, including identifying which mandates, consumer protections, and subsidies will be lost and which have equivalents in state law.
2. Study the adequacy of the state’s insurance laws on regulating the introduction of insurtech products into the Texas insurance market. Include in the study the impact of big data, blockchain, internet of things, and artificial intelligence technologies on industry practices such as claims handling, underwriting, and policy writing. Study whether these technologies present challenges for any of the state’s insurance laws, including the state’s anti-discrimination, data privacy, anti-rebate, and licensing laws and regulations. Additionally, examine the pros and cons of adopting a regulatory sandbox and consider sandbox programs that are implemented in other states.
3. Monitor the State Auditor's review of agencies and programs under the Committee's jurisdiction. The Chair shall seek input and periodic briefings on completed audits for the 2019 and 2020 fiscal years and bring forth pertinent issues for full committee consideration.
Committee: Senate State Affairs
Title: Interim Report
Subjects: Biometric identification | Cellular telephones | DNA databases | e-government | Electronic surveillance | Employees Retirement System of Texas | Health care costs | Health care navigators | Health insurance exchanges | Health insurance pools | Legislature, Texas | Medical billing | Patents | Patient Protection and Affordable Care Act | Personally identifiable information | Privacy | Rules of the Texas Senate | Search warrants | Searches and seizures | Small businesses | Teacher Retirement System of Texas | Texas Health Insurance Risk Pool | Texas Legislature Online | Texas Mutual Insurance | Websites | Workers' compensation |
Library Call Number: L1836.83 St29a
Session: 83rd R.S. (2013)
Online version: View report [128 pages]
Charges: This report should address the charges below.
1. Examine the negative economic impact on Texas business from legal issues involving threatened and actual patent litigation by "patent assertion entities" (PAEs). Consider the effects of PAE actions on innovation and economic development in Texas, paying particular attention to threats and lawsuits involving software and technology patent claims. Make recommendations on how the State of Texas can address problems related to frivolous legal actions and unsubstantiated patent claims asserted against legitimate business enterprises in light of the relevant federal jurisdiction, laws, regulations, and court rules in patent cases.
2. Examine possible measures to protect the personal privacy of Texas residents from governmental and commercial surveillance, including: (1) any necessary limits on warrantless search and seizure of data from electronic devices and wireless providers, including digital content and geolocational data; (2) any necessary protections against non-consented video and audio recordings collected by private handheld and wearable mobile devices and other private surveillance; and (3) any necessary limits on warrantless monitoring of the physical location of individuals through the use of biometrics, RFID chips, facial recognition, or other technologies. Examine related measures proposed or passed in other states.
3. Review the types and scope of personal data collected by governmental and commercial entities and consider methods to minimize the government’s collection of data on its citizens. The study should include: (1) whether sufficient protections exist for DNA samples and information, including whether there should be a prohibition on the creation of DNA databases, except for felons and sex offenders; (2) methods to protect the privacy of gun owners from aggregated purchasing pattern tracking; (3) mechanisms to ensure that private health care information is properly protected; and (4) ways to ensure that previously anonymous data is not improperly re-identified and marketed. Examine related measures proposed or passed in other states.
4. Examine possible reforms designed to increase citizens' ability to know what data is being collected about them by governmental andcommercial entities and with whom that data is being shared, including an analysis of consumer informed consent. Examine related measures proposed or passed in other states.
5. Study the online legislative resources available to the public from Texas Senate Committee websites and compare esources to those provided by other state legislative committees in Texas and other states. Determine how Texas Senate websites can be improved to provide a more interactive and transparent government.
6. Study the emerging negative impacts of the Federal Affordable Care Act, including the use of navigators, and make recommendations to mitigate any unintended consequences including rising health insurance premiums, lack of access to healthcare, mishandling of Texans' private information by insufficiently-trained navigators, and the Act’s overall effect on Texas employers and insurance consumers. Evaluate free-market alternatives to the Act, including state-led proposals to repeal, reduce or replace the Act. Closely monitor and make recommendations on the continuation of the Texas Health Insurance Pool.
7. Study and make recommendations on increasing medical price transparency in Texas, including studying the impact of SB 1731, 80th Legislative Session. Analyze relevant reforms considered or implemented in other states, and make recommendations regarding potential changes designed to create a more open marketplace for enhanced consumer decision making in Texas.
8. Monitor the actuarial and financial conditions of the pension and health care programs administered by the Teacher Retirement System (TRS) and the Employees Retirement System (ERS).
9. Monitor the implementation of legislation addressed by the Senate Committee on State Affairs, 83rd Legislature, Regular Session, and make recommendations for any legislation needed to improve, enhance, and/or complete implementation.
10. Study and make recommendations relative to the structure of Texas Mutual Insurance Company and the residual market for workers’ compensation insurance in Texas.
Committee: Senate State Affairs
Title: Interim Report
Subjects: Eight-liners | Election fraud | Employees Retirement System of Texas | Entergy Corporation | Gambling | Health care costs | Health insurance | Health maintenance organizations | Insurance industry | Investment of public funds | Legislative intent | Medical research | Medically uninsured | Mental health services | Mentally ill inmates | Mentally ill persons | Privatization | Public retirement systems | Statutory revision | Strategic Lawsuits Against Public Participation | Texas Health Insurance Risk Pool | Texas Lottery | Tort reform | Voter identification | Voting systems | Workers' compensation |
Library Call Number: L1836.80 St29a
Session: 80th R.S. (2007)
Online version: View report [308 pages  File size: 43,740 kb]
Charges: This report should address the charges below.
1. Study the factors that impact the transparency and efficiency of the health insurance market. Make recommendation to result in the use of best practices, lower health care costs, and better health outcomes, including the following:
  • Study factors contributing to the increasing cost of health care;
  • Study insurer and health maintenance organization (HMO) use of tiers, ratings, or classifications to differentiate among credentialed physicians already admitted to the insurer or HMO panel of preferred providers or network;
  • Examine methods to remediate incorrect tiering, ratings, or classifications;
  • Examine how physicians are notified of the standards against which they will be compared and whether they are notified of the standards prior to the evaluation period;
  • Improve transparency with respect to the marketing of prescription drugs; and
  • Study the use of certain nonprofit health corporations - approved under Chapter 162, Occupations Code, in Texas. Examine whether such entities operate on a statewide scale or on a limited scale, whether such entities adhere to the formalities required of corporations, whether the operation of such entities are influenced by owners or members who are not licensed to practice medicine, and whether such entities have ever been decertified or investigated for failure to maintain compliance with Texas law or regulations.
2. Study and make recommendations for reducing the number of uninsured Texans, focusing on the following:
  • Options to increase access to private health insurance, including 3 Share programs, employer sponsored plans and portable, individual insurance;
  • Incentives for encouraging counties and local governments to participate in private health insurance cost sharing for their respective residents;
  • Options to reduce health care premiums, including creation of special plans with increased deductibles and catastrophic coverage;
  • Implementation and possible expansion of health services districts;
  • Other state programs for increasing market-based coverage of the uninsured, including costs and effectiveness;
  • Options that will increase consumer choice and personal responsibility; and
  • Analysis of state and federal regulations that contribute to higher premium costs.
3. Study and make recommendations relating to the Texas Health Insurance Risk Pool, including the current eligibility for coverage requirements, the economic profiles of participants and former participants, the affordability of the insurance products’ premiums and deductibles, and the public's awareness of the Pool.
4. Study the issue of security and accuracy in Texas elections. The study should include the benefits and risks of electronic voting technology, including the necessity of maintaining a paper record of each electronic vote. The study should also include an analysis of fraud in Texas elections, including prosecution rates for voter fraud, the processes for purging ineligible voters from voter lists, and the integrity of the mail-in and provisional ballot systems. Study the effectiveness of electronic voting technology and voter ID laws in other states. Monitor the implementation of the federal Help America Vote Act of 2002, including the implementation of the Texas Election Administration Management system. Recommend statutory and regulatory changes designed to ensure that only eligible voters are allowed to vote in Texas elections and that each vote is accurately counted.
5. Review and make recommendations for requiring insurance coverage of routine medical care for patients with a life-threatening disease or condition who have elected to participate in a clinical trial.
6. Study the economic impact of recent civil justice reform legislation in Texas.
7. Study whether Texas should adopt the Restatement 2nd of Torts Sec. 674 (Wrongful use of Civil Proceedings) and whether a person should be allowed to recover court and attorneys fees when he has been forced to defend a lawsuit filed without probable cause or for intimidation purposes.
8. Monitor the Texas workers' compensation system, and the continued implementation of the reforms of HB 7, 79th R.S., by the Texas Department of Insurance and other state agencies. Specifically evaluate the recent decision by the Texas Supreme Court in Entergy v. Summers in terms of its impact and the impact of previous legislation on the workers' compensation system.
9. Study and make recommendations to reduce illegal gambling in Texas, including, but not limited to, the illegal use of Eight-Liners.
10. Analyze the advantages and disadvantages of phasing in a defined-contribution pension for future employees versus the existing defined-benefit pension plan. Study options for transition or implementation issues and how the phase-in could be structured. Evaluate the possibility of requiring the state employee contribution rate to meet the annually required contribution for the statewide retirement funds each biennium in order to prevent unfunded liabilities.
11. Study the relationship between the public mental health system and the criminal justice and civil courts systems, including the identification and sharing of information regarding mentally ill offenders, including minors, among criminal justice and mental health agencies, the courts, state hospitals, and the Veterans Administration. Study how current confidentiality laws impact the exchange of information among groups described above. Study the sentencing of mentally ill offenders compared to non-mentally ill offenders, including minors, and the affect that has on statewide prison capacity and on the quality of health care provided to mentally ill offenders. (Joint charge with Senate Criminal Justice Committee)
12. Review and evaluate appropriate state regulation of a private operator of the state lottery should the state receive bids for a lease of the lottery that merit strong consideration. Provide recommendations for ensuring the security and integrity of the lottery and for adequate consumer protections. (Joint charge with Senate Finance Committee)
13. Study the feasibility and the advisability of establishing an investment policy that is consistent across all state trust funds, including the trust funds of the Employees Retirement System, the Teachers Retirement System, the Permanent University Fund, and the Permanent School Fund. Identify best investment policies for state trust funds. Examine recent portfolio diversification strategies and the effect they have on long-term fund performance. The recommendations should consider what is an acceptable rate of return, an acceptable degree of risk, the appropriateness of certain investments. (Joint charge with Senate Finance Committee)
14. Monitor the implementation of legislation addressed by the State Affairs Committee, 80th R.S., and make recommendations for any legislation needed to improve, enhance, and/or complete implementation. In particular, monitor and report on the effect of HB 2365, 80th R.S., which allows public entities to report "other post employment benefits" (OPEBs) on a statutory modified accrual basis, including any effect on auditor opinions, bond ratings, or other fiscal issues. Monitor the implementation of SB 1731, 80th R.S., relating to transparency of health information, and SB 1846, 80th R.S., relating to TRS.

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