TX HB1959

Health maintenance organizations and insurers may offer incentives (modified deductibles, copayments, coinsurance) to encourage enrollees to use certain physicians or health care providers

Insurers that steer patients to specific providers or use tiered network plans now have a fiduciary duty to act primarily for the benefit of the enrollee or policyholder, not the insurer's own interests

Health benefit plan issuers can only rank or classify physicians into performance-based tiers if they use standards developed by organizations designated by the Insurance Commissioner

Physicians must receive at least 45 days' notice before any ranking or tier classification is released to enrollees, with identification of which products or networks will use the evaluation

Physicians must be given an easy-to-use process to identify discrepancies in their rankings, and issuers must remedy confirmed discrepancies by publication date or within 30 days of receiving the information