TX HB3845

Prohibits payors from compensating utilization review agents or conditioning contracts based on the volume of adverse determinations, benefit reductions, or frequency of contacts with providers/patients

Bars utilization review agents from basing employee compensation, performance evaluations, or employment decisions on the number of claim denials or benefit limitations

Prohibits utilization review agents from pressuring employees to make adverse determinations or retaliating against employees who refuse to deny claims or limit benefits

Creates a private right of action for employees who face retaliation for reporting violations, with recoverable damages including at least $1,000 or actual damages, exemplary damages, lost wages, mental anguish, and attorney's fees

Establishes a rebuttable presumption of retaliation if an employee is suspended or terminated within 60 days of reporting a violation, and allows for reinstatement as injunctive relief