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7 Document(s) [ Subject: Prompt payment of insurance claims ]

Committee: Senate Business and Commerce
Title: Interim Report
Subjects: Delinquent taxes | Elder abuse | Electronic security | Employment eligibility verification | Hailstorms | Health insurance | Liens | Medical bill balance billing | Occupational licenses | Prompt payment of insurance claims | Property insurance | Public information | State employees | Texas Windstorm Insurance Association | Undocumented immigrants |
Library Call Number: L1836.84 B963
Session: 84th R.S. (2015)
Online version: View report [72 pages]
Charges: This report should address the charges below.
1. Occupational Licensing: Review all occupations licensed under Texas law to determine the extent to which continued state regulation and licensure is required to protect public health and safety. Examine methods to ensure greater legislative oversight of new regulations, scope, and necessity of certain licenses and make recommendations for state licenses that should be repealed or transitioned to private-sector enforcement.
2. Hail Storm: Monitor the number of lawsuits related to property claims filed as a result of multiple hail storms and weather related events across Texas. Examine negative consumer trends that may result in market disruption such as higher premiums and deductibles, less coverage, non-renewals, and inability to secure coverage due to insurance carrier withdrawal from the state and make recommendations on legislative action needed.
3. Texas Prompt Pay Law: Study the impact of the penalty calculations under the current prompt payment of health care claim laws and regulations, including comparing penalties in other states and late payment penalties in Texas for other lines of insurance. Evaluate whether unregulated billed charges is the appropriate basis for determining penalty amounts and make recommendations for statutory changes, if needed.
4. Cyber-security/Storage: Examine cyber-security efforts undertaken by state entities and study the legal, policy, and privacy implications of the trend toward storage of personal, private, and business confidential information in network attached storage, cloud storage, and other developing data storage options rather than on local devices. Make recommendations on how to best protect Texans’ financial and personal information.
5. Elder Financial Abuse: Study elder financial abuse and determine what steps the State of Texas should take to help protect older Texans from financial exploitation.
6. Property Tax Liens: Examine and make recommendations for necessary changes regarding the collection process of delinquent ad valorem property taxes, including an inquiry into the role that tax lien transfers play in forestalling foreclosure.
7. Monitoring Charge: Monitor the implementation of legislation addressed by the Senate Committee on Business and Commerce during the 84th R.S. and make recommendations for any legislation needed to improve, enhance, and/or complete implementation. Specifically, monitor the following: 1) State agency participation in the federal electronic verification of employment authorization program; 2) Implementation of legislation intended to further protect consumers from the balance billing process; 3) Changes made to the operation of the Texas Windstorm Insurance Association; 4) The regulation of public insurance adjusters; and 5) The current consent policy for state disclosure of personal data.
Committee: House Insurance
Title: Interim Report
Subjects: Assisted living facilities | Fraud | Health care provider networks | Health insurance | Insurance industry | Insurance, Texas Department of | Medical bill balance billing | Prompt payment of insurance claims | Property insurance | Texas Mutual Insurance | Texas Windstorm Insurance Association | Windstorm insurance | Workers Compensation Commission, Texas | Workers' compensation |
Library Call Number: L1836.84 In7
Session: 84th R.S. (2015)
Online version: View report [87 pages]
Charges: This report should address the charges below.
1. Examine available data on the cost of weather-related property insurance claims and the incidence of litigation of these claims. Study whether these data reveal trends or patterns over time and what the drivers of these trends might be. Identify impacts on the property insurance market and on consumers from claims litigation.
2. Examine the effectiveness of previous legislative efforts to encourage transparency and adequacy of health care networks, and of legislation to protect consumers from the negative impacts of disputes over out-of-network services. Study whether enhancements in transparency or regulation are necessary.
3. Evaluate the statutory penalty calculations under Texas's prompt payment laws regarding health care claims. Include an analysis of whether the proper benchmarks are used to establish penalties commensurate with an improper payment and the effect of the abolition of the Texas Health Insurance Pool on the use of funds collected under the statute.
4. Study the Texas credit for reinsurance statutes and how they affect market capacity, the cost of regulatory compliance, and the prospect of federal preemption of the state's ability to regulate reinsurance. Examine how alternative credit for reinsurance statutes in other jurisdictions function, including in the regulatory and legal systems of those jurisdictions.
5. Monitor the implementation of SB 900 (84R), including the rulemaking process by the Texas Department of Insurance and the adoption of an updated plan of operation by the Texas Windstorm Insurance Association.
6. Examine the effectiveness of residual market programs in the insurance industry in Texas, as well as approaches used in other states.
7. Review the implementation of HB 2929, 83rd R.S.. Examine the bill's impact and compliance among affected health plans. Examine the costs incurred by the Employees Retirement System, Teacher Retirement System, and any other affected state health plans as a result of the legislation.
8. Review current statutory provisions regarding the prosecution of workers' compensation insurance fraud. Examine ways to maintain or enhance fraud prosecution while ensuring a fair process for all parties involved.
9. Conduct legislative oversight and monitoring of the agencies and programs under the committee’s jurisdiction and the implementation of relevant legislation passed by the 84th Legislature. In conducting this oversight, the committee should: a. consider any reforms to state agencies to make them more responsive to Texas taxpayers and citizens; b. identify issues regarding the agency or its governance that may be appropriate to investigate, improve, remedy, or eliminate; c. determine whether an agency is operating in a transparent and efficient manner; and d. identify opportunities to streamline programs and services while maintaining the mission of the agency and its programs.
Supporting documents
Committee: House Insurance
Title: Committee meeting handouts and testimony, March 30, 2016 (Prompt pay, post-acute brain injury care, workers' compensation fraud)
Library Call Number:
Session: 84th R.S. (2015)
Online version: View document [168 pages  File size: 17,722 kb]
Committee: Senate Health and Human Services
Title: Interim Report
Library Catalog Title: Interim report to the 79th Legislature
Subjects: Adult Protective Services | Call centers | Child Protective Services | Children's Health Insurance Program | Databases | Family and Protective Services, Texas Department of | Health care | Hospitals | Immunizations | Indigent health care | Long-term care | Medicaid | Medicaid fraud | Medical Board, Texas | Medicare | Prompt payment of insurance claims | Social service agencies | State government reorganization | Welfare |
Library Call Number: L1936.78 H349
Session: 78th R.S. (2003)
Online version: View report [247 pages  File size: 1,485 kb]
Charges: This report should address the charges below.
1. Study and make recommendations on structural reform, efficiency improvements, and cost savings in the state Medicaid and CHIP programs, with a goal of changing the method and delivery of service to reduce costs while providing the intended services. The Committee should examine and make recommendations to: lower institutional costs; subsidize private insurance in lieu of Medicaid and CHIP where possible; use consumer-directed care models; reimburse health care providers based upon outcomes where feasible; match currently unmatched local funds with federal funds; alter Texas' current method of finance and distribution of DSH; develop possible HIFA waiver options that incorporate premium subsidization; develop accountability and incentive measures for outcomes within Medicaid managed care and CHIP; seek flexibility from federal government to allow options and waivers and enhance federal funds; examine local models for delivery of Medicaid while maintaining best practices; and expand access to mental health services through expansion of behavioral health organization model. The Committee will coordinate these studies with the Health and Human Services Transition Legislative Oversight Committee review of mental health and mental retardation services.
2. Monitor implementation and make recommendations to improve HB 2292, 78th R.S.. Include reviews of implementation of the preferred drug list and prior authorization and the new call center for determination of program and service eligibility. The Committee will coordinate activities with the Health and Human Services Transition Legislative Oversight Committee.
3. Study and make recommendations on improving Texas's county and local indigent health care system. Consider whether the system should be regionalized to reflect usage and gain efficiencies, so that one or more counties are not paying for regional health care.
4. Monitor the implementation and make recommendations to enhance the effectiveness of legislation relating to the Board of Medical Examiners, legislation relating to childhood immunizations, legislation relating to the pilot front end Medicaid fraud reduction systems, federal developments related to TANF reauthorization and related programs, expansion and new construction of Federally Qualified Health Centers, federal developments related to prescription drugs in Medicare and the effect on Medicaid. Also, monitor and report on the use of new federal Medicare funds allocated for Texas
5. Study and make recommendations on increasing electronic transactions in health care. Review the use and make recommendations on improving technology in health care administration, including expediting pre-authorizations and increasing the efficiency of claims processing so that medical providers are paid once procedures are pre-authorized and performed, and administrative costs lowered, benefitting both the consumer and the managed health care organizations.
6. Study health facility regulation in Texas and make recommendations that facilitate innovation and patient safety. Concentrate studies on hospitals, including niche hospitals, Federally Qualified Health Centers and long term care facilities, and make recommendations for improving patient choice, facility competition, indigent health care, and for maintaining a competitive, patient-oriented health care industry.
7. Study and make recommendations on improving the Protective and Regulatory Services service levels payment system and tiered adoption subsidy program. Study and make recommendations on improving the recruitment and retention of foster care families.
Committee: Senate Prompt Payment of Health Care Providers, Special
Title: Interim Report
Library Catalog Title: Interim report to the 78th Legislature / Texas Special Committee on Prompt Payment of Health Care Providers.
Subjects: Health insurance | Medical liability insurance | Medical malpractice | Prompt payment of insurance claims | Tort reform |
Library Call Number: L1836.77 p944
Session: 77th R.S. (2001)
Online version: View report [155 pages  File size: 3,563 kb]
Charges: This report should address the charges below.
1. The Committee shall evaluate the effectiveness of existing state law and agency rules designed to ensure prompt payment of health insurance claims to providers by insurance companies. The Committee should assess the level of industry compliance with current law and the necessity of additional enforcement measures. The Committee shall determine the factors affecting the timeliness of reimbursements and make necessary recommendations to improve the process.
2. The committee shall evaluate the effectiveness of existing state law and agency rules relating to the current medical professional liability system. The committee should assess the causes of rising malpractice insurance rates in Texas, including the impact of medical malpractice lawsuits, and their impact on access to health care. Based on that assessment, the committee should determine the need for corrective action and make recommendations as necessary.
Committee: Senate Health and Human Services, Interim
Title: Interim report
Library Catalog Title: Texas Senate Interim Committee on Health and Human Services interim report.
Subjects: Immigration | Medicaid fraud | Medical billing | Prompt payment of insurance claims | Rural issues | Rural population | Senior citizens | Tobacco advertising | Tobacco laws and regulations | Tobacco lawsuit | Tobacco settlement receipts | Underage smoking | Welfare | Welfare fraud | Welfare reform |
Library Call Number: L1836.75 h349
Session: 75th R.S. (1997)
Online version: View report [160 pages  File size: 7,598 kb]
Charges: This report should address the charges below.
1. Monitor the implementation of SB 30, 75th R.S., passed by the Legislature during the 1997 regular session, regarding fraud and improper payments under state Medicaid and welfare programs. If needed, make recommendations for further legislative and regulatory action.
2. Develop a plan for oversight of efforts by state health and human services agencies, the Attorney General, and law enforcement agencies, to detect and reduce fraud and improper payments under state Medicaid and welfare programs. The plan should address enforcement and punishment under state and federal civil and criminal laws.
3. Continue to monitor federal welfare reform, and make recommendations for necessary legislative or regulatory action.
4. Study the implementation of SB 55, 75th R.S., passed by the Legislature during the 1997 regular session, regarding minors' access to tobacco.
5. Monitor developments in the federal tobacco settlement discussions and identify potential, fiscal impacts to Texas governments.
6. Examine the demographic trends of the state that will impact the health and human services delivery system in the future, including immigration, rural concerns, and the aging state population. Make recommendations for research and legislative action, if necessary.
7. Study current practices in patient billing by Texas hospitals and providers of health care to evaluate the accuracy, clarity and timliness of patient billing. The Committee should examine existing regulatory authority and determine whether there is suficient authority to address problems in patient billings. If necessary, the Committee may make recommendations for standardizing patient billing; ensuring that bills are accurate and complete yet simple enough for patients to understand; providing a meaningful appeals process for incorrect or excessive billings; and establishing guidelines for submission of bill for payment within a reasonable time period.
Committee: House Insurance
Title: Interim report
Library Catalog Title: House Committee on Insurance, Texas House of Representatives interim report, 1998 : a report to the House of Representatives, 76th Texas Legislature.
Subjects: Automobile insurance | Banks and banking | Health insurance | Homeowners insurance | Insurance industry | Insurance rates | Insurance, Texas Department of | Prompt payment of insurance claims | State mandates |
Library Call Number: L1836.76 IN7
Session: 75th R.S. (1997)
Online version: View report [104 pages  File size: 3,310 kb]
Charges: This report should address the charges below.
1. Conduct active oversight of the agencies under the committee's jurisdiction.
2. Study the incremental costs of health insurance benefits mandated by the legislature. Explore ways for the legislature to obtain accurate information on the costs of mandates proposed by legislation. Evaluate the effects, if any, of currently mandated benefits on premium costs, the market, and access to coverage.
3. Review issues related to insurance company claims handling and the laws relating to failure to handle claims in good faith.
4. Conduct a review of the various lines of insurance and the extent to which the lines are regulated as to (1) premium rates, (2) policy forms, (3) financial integrity, (4) market conduct, and (5) other factors determined by the committee.
5. Monitor federal banking reform initiatives to see that state interests in the regulation of financial institutions and insurance companies are protected. (Joint with the House Committee on Financial Institutions)

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