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HB 10 data collection index page

Report due date – May 1, 2018

This page contains the following sections:



Background information

The 85th Legislature passed House Bill 10 directing the Texas Department of Insurance and the Health and Human Services Commission to conduct studies and prepare reports on benefits for medical or surgical expenses and for mental health conditions and substance use disorders.

The studies require the agencies to collect and compare data from health benefit plan issuers subject to Insurance Code Chapter 1355, Subchapter F (as added by the bill) on medical or surgical benefits and mental health condition or substance use disorder benefits that are:

  • subject to prior authorization or utilization review;
  • denied as not medically necessary or experimental or investigational;
  • internally appealed, including data that indicates whether the appeal was denied; or
  • subject to an independent external review, including data that indicates whether the denial was upheld.

This request is made pursuant to Texas Insurance Code §38.001 and applies to issuers who report to the National Association of Insurance Commissioners (NAIC) covered lives of 25,000 or more as of the last day of the reporting period. This threshold applies separately to individual, small group, and large group comprehensive health coverage and is not a total of the three categories combined. Issuers who do not meet the threshold for any of the categories are exempt from reporting for that particular category.  This request is made pursuant to Texas Insurance Code §38.001.



Instructions - Revised April 19, 2018

House Bill 10 Data Collection Instructions for Reporting (PDF)



Reporting forms

House Bill 10 Data Plan (xlsx)

House Bill 10 Survey Data Collection Reporting Form (xlsx)



Stakeholder meeting

On October 30, 2017, TDI and HHSC conducted a stakeholder meeting to solicit comments from interested parties concerning the data reporting requirements of HB 10.

Agenda



Additional resources

House Bill 10 (link to Texas Capitol)

House Bill 10 Data Collection FAQs (PDF)


 


 

For more information, contact:

Last updated: 4/23/2018