TX HB2320

Requires managed care plans that mandate specialist referrals to accept referrals from primary care providers when the enrollee has had at least one prior visit with the provider and the referral is for a chronic or ongoing condition

Allows managed care plans to refuse referrals if more than three years have passed since the referral was made, the provider has withdrawn it, the enrollee's primary care provider has changed, or the plan issuer/administrator has changed

Applies to health maintenance organizations and plans requiring referrals for network benefits, including state employee basic coverage plans (Chapter 1551), teacher retirement plans (Chapter 1575), and school employee primary care plans (Chapter 1579)

Exempts Medicaid managed care programs from these referral requirements

Takes effect September 1, 2025, and applies to health benefit plans delivered, issued, or renewed on or after January 1, 2026