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HB 10 Data Collection Index Page

Report due date – to be announced

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.

Comprehensive health plan issuers with considerable business in the individual, small group, and large group markets, as well as all Medicaid managed care organizations, are subject to the data call.


 
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.  At this meeting stakeholders requested additional time to provide comments, and TDI and HHSC agreed to extend the comment period.  Comments on HB 10 data reporting requirements will be accepted by email to HealthSurveys@tdi.texas.gov until the close of business on Friday, November 17, 2017.

Agenda



Additional Resources

House Bill 10 (link to Texas Capitol)



Instructions

Will be added later.



Reporting Form

This is a draft of the proposed HB 10 data reporting form that was first reviewed at the October 30, 2017, stakeholder meeting as a model for data collection.

House Bill 10 Reporting Form - PROPOSED 10-20-2017



For more information, contact:

Last updated: 11/02/2017

Contact Information and Other Helpful Links