Texas HB4037 mandates anesthesia coverage and patient assessment requirements for specific health benefit plans.

HB4037 amends the Texas Insurance Code to require health benefit plans to cover medically necessary anesthesia for the full duration of services. It mandates that these plans account for patient physical status and care complexity in determining service necessity and payment amounts. The law applies to small employer health benefit plans, standard health benefit plans, basic coverage plans, and primary care coverage plans, effective from January 1, 2026. The changes in law apply to plan years commencing on or after January 1, 2026.

Texas HB4037 mandates anesthesia coverage and patient assessment requirements for specific health benefit plans.

HB4037 amends the Texas Insurance Code to require health benefit plans to cover medically necessary anesthesia for the full duration of services. It mandates that these plans account for patient physical status and care complexity in determining service necessity and payment amounts. The law applies to small employer health benefit plans, standard health benefit plans, basic coverage plans, and primary care coverage plans, effective from January 1, 2026. The changes in law apply to plan years commencing on or after January 1, 2026.