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3 Document(s) [ Subject: Medical bill balance billing ]

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of new regulations, scope, and necessity of certain licenses and make recommendations for state licenses that should be repealed or transitioned to private-sector enforcement.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 Legislature, Regular Session 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 (83R). 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.
Committee: Senate State Affairs
Title: Interim Report
Library Catalog Title: Interim report to the 80th Legislature
Subjects: Child Protective Services | Election fraud | Emergency medical services | Eminent domain | Employees | Employees Retirement System of Texas | Employers | Employment | Health care costs | Health maintenance organizations | Liability | Lobbyists | Medical bill balance billing | Privatization | Public retirement systems | State mandated health insurance | Teacher Retirement System of Texas | Voter identification | Voting by mail | Workers' compensation |
Library Call Number: L1836.79 St29a
Session: 79th R.S. (2005)
Online version: View report [211 pages  File size: 6,521 kb]
Charges: This report should address the charges below.
1. Study the Employees Retirement System of Texas ("ERS") including the actuarial soundness of the ERS pension fund; the implementation of cost-saving measures in the ERS group health insurance plan; the suggestion of further cost-saving measures such as the implementation of a 3-tiered provider network; the effectiveness of the third party administrator of the ERS group health insurance plan in managing inflation; and the feasibility of consolidating the administration of all state group health plans under a single state agency.
2. Study the Teachers Retirement System of Texas ("TRS") including the actuarial soundness of the TRS pension fund; the implementation of cost-saving measures in the TRS group health insurance plan; the suggestion of further cost-saving measures such as the implementation of a 3-tiered provider network; the implementation of SB 1370, 79th Legislature, Regular Session; the effectiveness of the third party administrator of the TRS group health insurance plan in managing inflation; and the feasibility of consolidating the administration of all state group health plans under a single state agency
3. Study and make recommendations on how election officials could verify the identity of a voter without hindering a person's right to vote. Include an analysis of the extent to which individuals are casting multiple votes because of any lack of voter identification verification. Make recommendations on how the state could improve its vote-by-mail system to ensure the authenticity of those ballots.
4. Monitor the implementation of HB 7, 79th Legislature, Regular Session, relating to the workers compensation system of this state.
5. Study the regulation and management of health care plans, including the following:
  • Study the reimbursement methodology of health care plans for out-of-network claims, the adequacy of health plan networks to provide appropriate coverage, the impact of out-of-network balance billing by physicians and health care providers and the accurate disclosure of patients' out-of-pocket costs.
  • Study the discounting and/or waiving of co-pays, deductibles and co-insurance by physicians and health care providers. Specifically, how this practice can impact the cost to private and public health plans and the impact to acute, multi-service hospitals, including safety net hospitals.
  • Evaluate health care cost transparency by health care providers and access to that information by patients.
  • Review data reported to the Texas Department of Insurance by health care plans, investigate possible expansion of health plans' reportable data, including, but not limited to, administrative costs, and what, if any, is the appropriate release and publication of that information.
6. Study and review current law on the doctrine of eminent domain, including the U.S. Supreme Court case in Kelo v. City of New London. Monitor the implementation of SB 7, 79th Legislature, 2nd Called Session, and make any necessary recommendations as to the use of eminent domain for economic development purposes and the issue of what constitutes adequate compensation for property taken through the use of eminent domain.
  • Determine whether a constitutional amendment is prudent and/or necessary to protect private property owners from condemnations for economic development purposes.
  • Determine which state, regional, and local governmental entities have eminent domain powers and how those powers may be used. Make recommendations regarding their necessity, fairness, and effectiveness.
  • Study the public policy implications relating to Chapter 2007, Government Code, Private Real Property Rights Preservation Act, its effectiveness in protecting private property rights, and the current impact of regulatory takings on private property owners.
7. Study the costs associated with mandates to insurance companies for increased coverage for specific illnesses, medical conditions, or diseases, including obesity. Provide a cost assessment of the impact of such mandates to the state and local units of government. Include data and analysis of the costs and medical impact associated with insurance mandates which have been enacted in other states, as well as any short- and long-term cost-savings. Develop recommendations on how to provide increased cost-effective coverage, especially to populations with impairments and diseases, as well as the underinsured/uninsured.
8. Study the prevalence, legality and ethics of entities that actively lobby the Legislature to impact the lawmaking process while that entity is in any way a recipient of state funds.
9. Study and make recommendations regarding the cost drivers of emergency medical services. Make recommendations on how to improve and sustain EMS services for Texas, as well as reduce costs to health care plans, businesses, and individuals.
10. Study and review current Texas law on the doctrine of statutory employer, including the 2004 First District Court of Appeals' decision in Etie v. Walsh & Albert Co. and make recommendations of changes in state laws, if necessary, regarding the doctrine of statutory employer and indemnification in construction contracts. Study the current use of Consolidated Insurance Programs and make legislative recommendations, if appropriate.
11. Assess the benefit of limiting the civil liability for noneconomic damages against non-profit organizations involved in the privatization of child welfare services.

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