TX SB1118

Health benefit plans that cover medically necessary anesthesia must provide coverage for the full duration of anesthesia services performed

Managed care plans under state employee and teacher health programs must ensure adequate provider networks by requiring coverage and payment calculations that account for patient physical status assessments and complexity/urgency of care as determined by the treating physician

Disease management services under state employee (Chapter 1551), teacher retirement (Chapter 1575), and school employee (Chapter 1579) health plans must consider patient physical status and complexity of care as identified by clinicians

Medical necessity determinations and benefit payment calculations for state employee and educator health plans must factor in both the patient's physical status assessment and the complexity/urgency of care as determined by the treating provider

Applies to health benefit plans delivered, issued, or renewed on or after January 1, 2026, with the law taking effect September 1, 2025