Texas HB4681 mandates preauthorization requirement disclosures and explanations of benefits for medical services by health maintenance organizations.
Texas HB4681 amends the Insurance Code to require health maintenance organizations and insurers to disclose preauthorization requirements and provide explanations of benefits for medical services. Insurers must notify insureds, physicians, and providers of new or amended preauthorization requirements and post these details on their websites. Health maintenance organizations must also provide written explanations of benefits to enrollees, detailing the services received and identifying codes.
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