Bill Text: TX SB2048 | 2021-2022 | 87th Legislature | Introduced
Bill Title: Relating to the telephone availability of certain personnel by certain health benefit plan issuers and utilization review agents.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2021-04-01 - Referred to Business & Commerce [SB2048 Detail]
Download: Texas-2021-SB2048-Introduced.html
By: Menéndez | S.B. No. 2048 | |
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relating to the telephone availability of certain personnel by | ||
certain health benefit plan issuers and utilization review agents. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Sections 843.347(c), Insurance Code, is amended | ||
to read as follows: | ||
(c) A health maintenance organization shall have | ||
appropriate personnel reasonably available at a toll-free | ||
telephone number to provide a verification under this section 24 | ||
hours a day, every day of the year, including on Saturdays, Sundays, | ||
and legal holidays [ |
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system capable of accepting or recording incoming phone calls for | ||
verifications during times when personnel are not available due to | ||
circumstances beyond the health maintenance organization's | ||
reasonable control [ |
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possible and in no event later than two hours after the call [ |
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SECTION 2. Section 843.348(f), Insurance Code, is amended | ||
to read as follows: | ||
(f) A health maintenance organization shall have | ||
appropriate personnel reasonably available at a toll-free | ||
telephone number to respond to requests for a preauthorization 24 | ||
hours a day, every day of the year, including on Saturdays, Sundays, | ||
and legal holidays [ |
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system capable of accepting or recording incoming phone calls for | ||
preauthorizations during times when personnel are not available due | ||
to circumstances beyond the health maintenance organization's | ||
reasonable control [ |
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possible and in no event [ |
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call is received. | ||
SECTION 3. Section 1301.133(c), Insurance Code, is amended | ||
to read as follows: | ||
(c) An insurer shall have appropriate personnel reasonably | ||
available at a toll-free telephone number to provide a verification | ||
under this section 24 hours a day, every day of the year, including | ||
on Saturdays, Sundays, and legal holidays [ |
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system capable of accepting or recording incoming phone calls for | ||
verifications during times when personnel are not available due to | ||
circumstances beyond the insurer's reasonable control [ |
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each of those calls as soon as possible and in no event later than | ||
two hours after [ |
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SECTION 4. Section 1301.135(e), Insurance Code, is amended | ||
to read as follows: | ||
(e) An insurer shall have appropriate personnel reasonably | ||
available at a toll-free telephone number to respond to requests | ||
for a preauthorization 24 hours a day, every day of the year, | ||
including on Saturdays, Sundays, and legal holidays [ |
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telephone system capable of accepting or recording incoming phone | ||
calls for preauthorizations during times when personnel are not | ||
available due to circumstances beyond the insurer's reasonable | ||
control [ |
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respond [ |
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in no event [ |
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received. | ||
SECTION 5. Section 4201.004(a), Insurance Code is amended | ||
to read as follows: | ||
(a) A utilization review agent shall: | ||
(1) have appropriate personnel reasonably available, by | ||
toll-free telephone available 24 hours a day, every day of the year, | ||
including on Saturdays, Sundays, and legal holidays [ |
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discuss patients' care and allow response to telephone review | ||
requests; | ||
(2) have a telephone system capable, during times | ||
when personnel are not available due to circumstances beyond the | ||
utilization review agent's reasonable control[ |
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telephone calls or of providing instructions to a caller; and | ||
(3) respond to a call made during times when personnel | ||
are unavailable due to circumstances described in subdivision (2) | ||
as soon as possible and in no event [ |
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after the call was received[ |
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SECTION 6. This Act takes effect September 1, 2021. |