(a) Each health maintenance organization and insurer shall submit to the department, in the form and manner prescribed by the commissioner, an annual written report, for each health care service subject to an exemption under Section 4201.653, on the:
- (1) exemptions granted by the health maintenance organization or insurer for the service;
- (2) determinations by the health maintenance organization or insurer to rescind or deny an exemption for the service, including the number of exemptions denied or rescinded by the health maintenance organization or insurer under Section 4201.655; and
(3) independent reviews of determinations conducted by an independent review organization under Section 4201.656, including:
- (A) the number of determinations made by the health maintenance organization or insurer for which a physician or provider requested an independent review under Section 4201.656; and
- (B) the outcome of each independent review described by Paragraph (A).
- (b) Subject to this subsection, a report submitted under Subsection (a) is public information subject to disclosure under Chapter 552, Government Code. The department shall ensure that the report does not contain any identifying information before disclosing the report in accordance with Chapter 552, Government Code.
Added by Acts 2025, 89th Leg., R.S., Ch. 640 (H.B. 3812), Sec. 8, eff. September 1, 2025.