The bill, titled "Laboratory Claim Integrity Programs," introduces Chapter 1224 to the Texas Insurance Code, establishing regulations for laboratory claim integrity programs associated with health benefit plans. It defines key terms such as "clinical laboratory test," "enrollee," and "health benefit plan issuer," and mandates that any person providing such programs must register with the department, with registration valid for three years and subject to renewal. The bill outlines the requirements for these programs, including the necessity to apply objective, evidence-based reimbursement policies and to provide a summary of the program on a public website.

Additionally, the bill specifies exemptions from registration for health benefit plan issuers and certain utilization review agents, while also detailing actions that cannot be classified as adverse determinations under Chapter 4201. The provisions of this chapter will apply only to contracts entered into or renewed after January 1, 2026, and the act is set to take effect on September 1, 2025.

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