88R6515 RDS-F     By: Paul H.B. No. 2403       A BILL TO BE ENTITLED   AN ACT   relating to the establishment of the Texas Health Insurance Mandate   Advisory Review Center; authorizing a fee.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Chapter 38, Insurance Code, is amended by adding   Subchapter J to read as follows:   SUBCHAPTER J. TEXAS HEALTH INSURANCE MANDATE ADVISORY REVIEW CENTER          Sec. 38.451.  DEFINITIONS. In this subchapter:                (1)  "Enrollee" means an individual who is enrolled in   a health benefit plan, including a covered dependent.                (2)  "Health benefit plan issuer" means an insurer,   health maintenance organization, or other entity authorized to   provide health benefits coverage under the laws of this state,   including a Medicaid managed care organization.                (3)  "Health care provider" means a physician,   facility, or other person who is licensed, certified, registered,   or otherwise authorized to provide a health care service in this   state.                (4)  "Health care service" means a service, procedure,   drug, or device to diagnose, prevent, alleviate, cure, or heal a   human disease, injury, or unhealthy or abnormal physical or mental   condition, including a service, procedure, drug, or device related   to pregnancy or delivery.                (5)  "Mandate" means a provision of a bill or joint   resolution that requires a health benefit plan issuer to:                      (A)  provide coverage for a health care service;                      (B)  increase or decrease payments to health care   providers for a health care service; or                      (C)  implement a new contractual or   administrative requirement.                (6)  "Mandate review center" means the Texas Health   Insurance Mandate Advisory Review Center established under Section   38.452.          Sec. 38.452.  ESTABLISHMENT OF MANDATE REVIEW CENTER. The   Center for Healthcare Data at The University of Texas Health   Science Center at Houston shall establish the Texas Health   Insurance Mandate Advisory Review Center to prepare analyses of   bills and joint resolutions that would impose new mandates on   health benefit plan issuers in this state.          Sec. 38.453.  REQUEST FOR ANALYSIS OF MANDATE. (a)     Regardless of whether the legislature is in session, the lieutenant   governor, the speaker of the house of representatives, or the chair   of the appropriate committee in either house of the legislature may   submit a request to the mandate review center to prepare and develop   an analysis of a proposed or enacted bill or joint resolution that   imposes a new mandate on health benefit plan issuers in this state.          (b)  A request submitted under this section must include a   draft of the bill or joint resolution prepared by the Texas   Legislative Council or a copy of an act of the Texas Legislature.          Sec. 38.454.  ANALYSIS OF MANDATE. (a)  On receiving a   request under Section 38.453, the mandate review center shall   conduct an analysis of, as applicable, the extent to which:                (1)  the mandate has increased or decreased or is   expected to increase or decrease total spending in this state for   any relevant health care service, including the estimated dollar   amount of that increase or decrease;                (2)  the mandate has increased or is expected to   increase the utilization of any relevant health care service in   this state;                (3)  the mandate has increased or decreased or is   expected to increase or decrease administrative expenses of health   benefit plan issuers and expenses of enrollees, plan sponsors, and   policyholders;                (4)  the mandate has increased or decreased or is   expected to increase or decrease the total spending by all persons   in the private sector, by public sector entities, including state   or local retirement systems and political subdivisions, and   individuals purchasing individual health insurance or health   benefit plan coverage in this state;                (5)  coverage for any relevant health care service is   or was, without the mandate, generally available or utilized; or                (6)  any relevant health care service is supported by   medical and scientific evidence, including:                      (A)  determinations made by the United States Food   and Drug Administration;                      (B)  coverage determinations made by the Centers   for Medicare and Medicaid Services;                      (C)  determinations made by the United States   Preventive Services Task Force; and                      (D)  nationally recognized clinical practice   guidelines.          (b)  In conducting an analysis under this section, the   mandate review center may consult with persons with relevant   knowledge and expertise.          Sec. 38.455.  REPORT. Not later than 60 days after receiving   a request under Section 38.453, the mandate review center shall   prepare a written report containing the results of the analysis   performed under Section 38.454 and:                (1)  deliver the report to the lieutenant governor, the   speaker of the house of representatives, and the appropriate   committees in each house of the legislature; and                (2)  make the report available on a generally   accessible Internet website.          Sec. 38.456.  FUNDING OF MANDATE REVIEW CENTER; FEE.  (a)     The department shall assess an annual fee on each health benefit   plan issuer other than an issuer operating solely as a Medicaid   managed care organization in the amount necessary to implement this   subchapter.          (b)  The mandate review center shall develop an annual cost   estimate of the amount necessary to fund the actual and necessary   expenses of implementing this subchapter.          (c)  The department shall, in consultation with the mandate   review center:                (1)  determine the amount of the fee assessed under   this section; and                (2)  adjust the amount of the fee assessed under this   section for each state fiscal biennium to address any:                      (A)  estimated increase in costs to implement this   subchapter; or                      (B)  deficits incurred during the preceding year   as a result of implementing this subchapter.          (d)  Not later than August 1 of each year, a health benefit   plan issuer shall pay the fee assessed under this section to the   department. The legislature may appropriate money received under   this section only to The University of Texas Health Science Center   at Houston to be used by the Center for Healthcare Data to   administer the center's duties under this subchapter.          (e)  The commissioner shall adopt rules to administer this   section.          SECTION 2.  Not later than January 1, 2024, the Center for   Healthcare Data at The University of Texas Health Science Center at   Houston shall establish the Texas Health Insurance Mandate Advisory   Review Center as required by Section 38.452, Insurance Code, as   added by this Act.          SECTION 3.  Not later than January 1, 2024, the commissioner   of insurance shall adopt rules as required by Section 38.456,   Insurance Code, as added by this Act.          SECTION 4.  This Act takes effect September 1, 2023.