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Bill

SB 547

Relating to notice from a health benefit plan issuer regarding a physician's or health care provider's preauthorization exemption status.

89th Legislature (2025) Introduced by Adam Hinojosa and 1 co-sponsor

Texas health insurers must inform patients which doctors have preauthorization exemptions, enabling faster access to care from those providers without prior insurance approval delays.

Referred to Insurance
#healthmaintenanceorganizations(s0853) #healthcareproviders(i0387) #insurance #texasdepartmentof(v0006) #insurance--health&accident(i0422) #insurance--insurers&agents(i0425)
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Bill Summary · SB 547

Legislative bill overview

SB 547 requires health benefit plan issuers in Texas to notify patients when their physician or healthcare provider has been granted an exemption from the preauthorization requirement. This ensures transparency about which providers can deliver care without needing prior approval from insurance companies before treatment.

Why is this important

Preauthorization delays can postpone necessary medical treatment, potentially worsening patient outcomes. By informing patients which providers have exemptions, this bill empowers patients to seek care from providers who can act faster and reduces administrative burdens that slow down treatment initiation.

Potential points of contention

  • Insurance industry burden: Health insurers may argue compliance creates administrative costs and complexity in tracking and communicating exemption statuses to patients
  • Scope ambiguity: The bill doesn't clearly define how notice must be delivered (written, digital, verbal) or when notifications must occur, potentially leading to inconsistent implementation
  • Incomplete solution: While notification helps patients, it doesn't address whether current preauthorization exemption criteria are appropriate or whether more providers should qualify for exemptions

Compiled from official sources — confirm details with the bill’s official record.

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