SRC-MWN H.B. 1610 77(R)   BILL ANALYSIS


Senate Research Center   H.B. 1610
By: Averitt (Fraser)
Business & Commerce
5/10/2001
Engrossed


DIGEST AND PURPOSE 

The impact of mandated benefits on the health insurance industry relating
to general cost and premium increases is under debate. Current law does not
require a health benefit plan issuer to collect and report cost and
utilization data for specific mandated benefits. Without accurate data on
the mandates, the state cannot study the impact. H.B. 1610 requires the
commissioner of insurance to designate by rule the health benefit plan
issuers that must collect and report cost and utilization data for specific
mandated benefits and mandated offers of coverage.  

RULEMAKING AUTHORITY

Rulemaking authority is expressly granted to the commissioner of insurance
in SECTION 1 (Section 38.252, Insurance Code) of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Chapter 38, Insurance Code, by adding Subchapter F, as
follows: 

SUBCHAPTER F.  DATA COLLECTING AND REPORTING RELATING TO
MANDATED HEALTH BENEFITS AND MANDATED OFFERS OF COVERAGE

Sec. 38.251.  APPLICABILITY. Provides that this subchapter applies to any
issuer of a health benefit plan that is subject to this code that provides
benefits for medical or surgical expenses incurred as a result of a health
condition, accident, or sickness, including an individual, group, blanket,
or franchise insurance policy or insurance agreement, a group hospital
service contract, or an individual or group evidence of coverage or similar
coverage document. 
 
Sec. 38.252.  COLLECTION OF INFORMATION; REPORT. (a)  Requires the
commissioner of insurance (commissioner) to require a health benefit plan
issuer to collect and report cost and utilization data for each mandated
health benefit and mandated offer designated by the commissioner. 
 
  (b)  Requires the commissioner to designate by rule certain criteria.

  (c)  Prohibits the commissioner from requiring reporting of certain data.

Sec. 38.253.  MAINTENANCE OF INFORMATION. Requires each health benefit plan
issuer to maintain at its principal place of business all data collected
pursuant to this subchapter, including information and supporting
documentation that demonstrates that the report submitted to the
commissioner is complete and accurate.  Requires each health benefit plan
issuer to make this information and any supporting documentation available
to the commissioner upon request. 

Sec. 38.254. (a)  Requires the Texas Health and Human Services Commission,
upon request from the commissioner, to provide to the commissioner data,
including utilization and cost data, which is related to the mandate being
assessed to the population covered by the Medicaid  program, including a
program administered under Chapter 32, Human Resources Code, and a program
administered under Chapter 533, Government Code, even if the program is not
necessarily subject to the mandate. 

(b)  Authorizes the commissioner to utilize data as defined in Subsection
(a) to determine the impact of mandated benefits and mandated offers of
coverage for which data collection and reporting is requested. 
 
SECTION 2. Effective date: September 1, 2001.