The bill, S.B. No. 884, establishes a shared savings program for certain managed care plans in Texas by adding Chapter 1276 to Subtitle C, Title 8 of the Insurance Code. This new chapter outlines definitions relevant to the program, including terms such as "health care provider," "managed care plan," and "out-of-network provider." It specifies that the program applies to nonemergency health care services covered under specific health benefit plans, including those provided by health maintenance organizations, preferred provider benefit plans, and basic coverage plans. The bill mandates that health benefit plan issuers or administrators create a shared savings program and provide written notice to enrollees.

Additionally, the bill includes provisions for average contracted rate disclosures, requiring health benefit plan issuers to establish a toll-free number and a publicly accessible website for enrollees to request information about average rates paid to providers. It also outlines the process for enrollees to receive shared savings payments if they choose a service that costs less than the disclosed rate, with specific conditions regarding deductibles and unforeseen charges. The provisions of this chapter will apply to health benefit plans delivered or renewed on or after January 1, 2026, and the act will take effect on September 1, 2025.

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