The bill, S.B. No. 1142, amends various sections of the Texas Insurance Code to prohibit health benefit plan issuers from requiring preauthorization for specific medical services and treatments. The new provisions include prohibiting preauthorization for screening mammograms, diagnostic imaging, reconstructive surgeries, inpatient care, diabetes equipment and supplies, bone mass measurements, diagnostic examinations for males, and screening examinations. Each of these amendments includes a clarification that the new rules do not authorize healthcare providers to deliver care outside their licensed scope.

The bill is set to apply to health benefit plans that are delivered, issued for delivery, or renewed on or after January 1, 2026, and it will take effect on September 1, 2025. The intent of the legislation is to streamline access to necessary medical services for patients by eliminating the preauthorization requirement, thereby potentially reducing delays in care.

Statutes affected:
Introduced: Insurance Code 1356.005, Insurance Code 1357.004, Insurance Code 1357.054, Insurance Code 1358.054, Insurance Code 1361.003, Insurance Code 1362.003, Insurance Code 1363.003 (Insurance Code 1356, Insurance Code 1363, Insurance Code 1361, Insurance Code 1357, Insurance Code 1362, Insurance Code 1358)