By: TAHP | Tuesday, June 20, 2023

Today, we launched our End-of-Session Highlights Guide for the 88th Texas Regular Session, explaining all of the health care, health insurance, and Medicaid-related legislation that passed. Consider it your quick-reference handbook.

Why it matters: This session made strides in several areas of health care, addressing many of TAHP’s top priorities.

• By the numbers: Throughout the 140 days, TAHP monitored 560 bills (of which 190 received a hearing), actively supported 57 bills, actively opposed 34 bills, negotiated 47 bills, testified 61 times, submitted 44 position cards, and submitted 51 written testimonies.

Here are the top 10 things to takeaway:

1. New Network Adequacy Requirements: With HB 3359, Texas health insurers have increased standards for network adequacy, along with new requirements for obtaining access waivers, including public hearings.
2. Medicaid Rx Reforms: The Medicaid statewide Preferred Drug List (PDL) will continue to be managed by HHSC for another 10 years (HB 1283). However, under HB 3286, the program now includes crucial patient safeguards to prevent patients from being switched from effective medications or denied due to shortages. Health plans will also now have three voting members in the decision-making process for determining preferred drugs.
3. Bans on Anti-Competitive Contracting: Texas is now a leader among states working to ban anti-competitive contracting between providers and health plans with the passage of HB 711. The bill includes prohibitions on anti-tiering, anti-steering, gag clauses, and most favored nation provisions. 
4. Texas Pharmaceutical Initiative: HB 4990 establishes a new initiative, funded with an $150 million appropriation, to develop a “business plan” for the potential creation of a statewide PBM, drug manufacturer, and pharmacy network to serve state-funded health programs.
5. Increased Flexibility for Medicaid Texting: HB 2802 aligns state law with federal guidance, streamlining the process for Texans to receive text messages and emails about changes to their Medicaid eligibility and other vital health care updates.
6. Itemized Hospital Billing Transparency: Texas took on the widespread medical debt collection crisis with a new law, SB 490, that ensures patients have access to an itemized hospital bill before being referred to collections.
7. Ambulance Surprise Billing Banned in Texas: SB 2476 builds upon existing surprise billing laws by implementing a temporary prohibition on out-of-network ambulance bills, aimed at protecting patients while Congress crafts a permanent solution.
8. Formulary Transparency: SB 622 creates a new requirement for health plans to provide real-time data to providers on patient out-of-pocket expenses and coverage information for prescription drugs. 
9. Focus on Women’s Health: This session Texas lawmakers expanded postpartum Medicaid coverage to 12 months (HB 12), created a new mandate for fertility services associated with cancer treatment (HB 1649), ensured women can receive a single, 12-month supply of contraceptives (HB 916), and established non-medical drivers of health (NDOH) screening criteria to assist pregnant women in accessing more Medicaid services (HB 1575).
10. Increased APCD Transparency: Building upon the All Payor Claims Database (APCD) established in the 87th Legislative Session, Texas law now permits third-party researchers to access data and publicly post price transparency reports identifying specific health care providers and health plans.

On June 28, we’ll host our end-of-session webinar: Register here.

• What you will learn: This TAHP webinar will bring you up to speed on the most important pieces of legislation impacting Texas Medicaid and the commercial health insurance market.