Texas 2025 - 89th Regular

Texas House Bill HB 1225

Voted on by House
 
Out of Senate Committee
 
Voted on by Senate
 
Governor Action
 
Bill Becomes Law
 

Caption

Relating to the establishment of a bundled-pricing program to reduce certain health care costs in the state employees group benefits program.

Impact

The implementation of HB 1225 is expected to have a significant impact on the way healthcare services are priced and provided to state employees. By requiring that all fees be bundled into a single rate, the bill seeks to eliminate unexpected costs and reduce the financial burden on employees undergoing procedures. Although participation in the program is voluntary for healthcare providers, it is anticipated that many will engage in the program to increase their patient flow from state employees who will benefit from the cost savings.

Summary

House Bill 1225 aims to establish a bundled-pricing program within the Texas state employees group benefits program, intended to reduce healthcare costs for state employees by offering consolidated rates for inpatient and outpatient surgical procedures. The legislation dictates that the board of trustees will develop this program and negotiate rates with participating healthcare facilities, physicians, and providers to create a cost-positive model that includes all fees related to the surgery procedure. This is designed to promote transparency in pricing and simplify the cost structure for employees seeking medical procedures under the state benefits program.

Contention

Notably, there may be contention surrounding participation by healthcare providers, as the bill explicitly states that no provider can be coerced into joining the program, nor can their participation influence their staff privileges or treatment scheduling. This provision aims to protect healthcare providers, but it could lead to disparities in access to bundled pricing, as some providers may opt-out of the program entirely. Additionally, discussions may arise concerning the implications of bundled pricing on the overall quality of care, as providers navigate cost management without compromising service standards.

Companion Bills

No companion bills found.

Previously Filed As

TX HB1883

Relating to coverage of medically necessary health care and treatment under the state employees group benefits program.

TX SF3123

State employee group insurance program utilization review pilot program establishment

TX A2149

Requires SHBP and SEHBP to implement referenced based pricing program and bundled payment program.

TX HB3254

Relating to the eligibility of members of the State Board of Education and their dependents to participate in the state employees group benefits program.

TX HB2655

Relating to operation by certain nonprofit organizations of certain regional health care programs for employees of small employers.

TX HB2300

Assessing employers for their workers' health care costs paid by the state.

TX HB515

To provide for the cost share of certain insurance premiums for programs sponsored by the state's Office of Group Benefits (OR INCREASE SG EX See Note)

TX SB2358

Relating to the establishment of an electronic health record loan program for certain health care facilities.

TX HB1061

Provides with respect to participation by certain retirees in insurance programs sponsored by the state's Office of Group Benefits

TX SB5883

Concerning eligibility for membership in the school employees' benefits board programs during the second school year of employment.

Similar Bills

NJ A504

"Health Care Consumer's Out-of-Network Protection, Transparency, Cost Containment and Accountability Act."

MA H2459

Relative to informed consent for concurrent surgical procedures

MI HB5522

Health occupations: physician's assistants; licensure of physician's assistants; modify. Amends (see bill).

LA SB7

Provides relative to surprise billing. (Item #37) (1/1/21) (EG INCREASE SG EX See Note)

NJ S2476

Provides that routine foot care services covered under certain insurance policies include coverage of services provided by podiatric physicians.

NJ S952

Allows physicians to jointly negotiate with carriers over contractual terms and conditions.

LA SB8

Establishes an independent dispute resolution process for certain health benefit claims. (Item #37)

CA SB1311

Licensed professions.