Initial review · graded Oct 20, 2026 · Headline, summary and grade are analysis of the bill text, not a finding about any person · How we grade
Caption
relating to notice from a health benefit plan issuer to the Texas
Department of Insurance regarding a physician's or health care
provider's preauthorization exemption status.
Every grant, denial or revocation reported to state regulators within 10 days.
The bill makes health insurers and HMOs that use preauthorization tell the Texas Department of Insurance, within 10 days, each time they grant, deny, continue, or take away a doctor's or provider's exemption from preauthorization, and each time an appeal on that decision is resolved. It touches insurers, HMOs, the doctors and providers who seek these exemptions, and the state insurance department. The department must keep a database of these decisions, tell any doctor or provider their own exemption status on request, and publish a yearly statistical report on evaluations, exemptions, and appeals by insurer, available to the public on request.
Labels
Labels: GOT HALFWAY. Passed the Senate on May 1, 2025. Died in the House: never got out of the Insurance committee.
relating to notice from a health benefit plan issuer to the Texas
Department of Insurance regarding a physician's or health care
provider's preauthorization exemption status.
WHAT IT DOES
Every grant, denial or revocation reported to state regulators within 10 days.
The bill makes health insurers and HMOs that use preauthorization tell the Texas Department of Insurance, within 10 days, each time they grant, deny, continue, or take away a doctor's or provider's exemption from preauthorization, and each time an appeal on that decision is resolved. It touches insurers, HMOs, the doctors and providers who seek these exemptions, and the state insurance department. The department must keep a database of these decisions, tell any doctor or provider their own exemption status on request, and publish a yearly statistical report on evaluations, exemptions, and appeals by insurer, available to the public on request.
CHARGES
[ ] NONE FOUND
TOTAL
Net to General Revenue · FY 2026$0
LBB estimate, flow · fiscal note version S · ( ) = negative · source
Sources
Fiscal note · version S · April 25, 2025
Estimated Two-year Net Impact to General Revenue Related Funds for SB547, Committee Report 1st House, Substituted: an impact of $0 through the biennium ending August 31, 2027. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
First year · FY 2026 · $0
Probable Net Positive/(Negative) Impact to General Revenue Related Funds
LBB published estimates · flow over the stated periods.
Source snapshot 2026-10-19, Central time.
HISTORY
Received by the Secretary of the Senate
Filed
Read first time
Referred to Health & Human Services
Scheduled for public hearing on . . .
Considered in public hearing
Testimony taken in committee
Left pending in committee
Considered in public hearing
Vote taken in committee
Reported favorably as substituted
Recommended for local & uncontested calendar
Committee report printed and distributed
Placed on intent calendar
Co-author authorized
Rules suspended-Regular order of business
Read 2nd time & passed to engrossment
Vote recorded in Journal
Three day rule suspended
Record vote
Read 3rd time
Passed
Record vote
Reported engrossed
Received from the Senate
Read first time
Referred to Insurance
FILED UNDER
No verified beat found.
SIGNED FOR BY
Senate · 31 yea · 0 nay
Sources
Senate: Final passage · May 1, 2025. Journal. Published stock for this vote. Snapshot 2026-10-19, Central time.
Names were not printed. No individual positions are inferred.
Sources
Senator Menéndez moved that Senate Rule 7.18 and the Constitutional Rule requiring bills to be read on three several days be suspended and that CSSB 547 be placed on its third reading and final passage. The motion prevailed by the following vote: Yeas 31, Nays 0. The bill was read third time and was passed by the following vote: Yeas 31, Nays 0.
Published stock of positions for this vote, except where marked derived.
Yea: 31 (published)
Nay: 0 (published)
Present, not voting: Not printed
Absent: Not printed
Excused: Not printed
Senate journal. Source snapshot 2026-10-19, Central time.
Names were not printed. No individual positions are inferred.
Sources
Senator Menéndez moved that Senate Rule 7.18 and the Constitutional Rule requiring bills to be read on three several days be suspended and that CSSB 547 be placed on its third reading and final passage. The motion prevailed by the following vote: Yeas 31, Nays 0.
Published stock of positions for this vote, except where marked derived.
Yea: 31 (published)
Nay: 0 (published)
Present, not voting: Not printed
Absent: Not printed
Excused: Not printed
Senate journal. Source snapshot 2026-10-19, Central time.
Names were not printed. No individual positions are inferred.
Voice vote. No numeric tally or individual yeas are inferred.
Sources
The bill was read second time and was passed to engrossment by a viva voce vote.
Published stock of positions for this vote, except where marked derived.
Yea: Not printed
Nay: Not printed
Present, not voting: Not printed
Absent: Not printed
Excused: Not printed
Senate journal. Source snapshot 2026-10-19, Central time.
Witnesses13
For
11
Against
0
On
2
Names
For
AstraZeneca1 registration
DHR Health1 registration
NAMI Texas1 registration
Patient Choice Coalition1 registration
Self; Texas Medical Association1 registration
Texas Academy of Family Physicians1 registration
Texas Ambulatory Surgery Center Society, Texas Dermatological Society, Texas Allergy, Asthma and Immunology Society, Federation of Texas Psychiatry1 registration
Texas Chapter American College of Physicians1 registration
Texas Hospital Association1 registration
Texas Orthopedic Association1 registration
Texas Pediatric Society1 registration
On
Texas Association of Health Plans1 registration
Texas Department of Insurance1 registration
Sources
13 parsed registrations across the loaded witness lists.
Derived stock of witness registrations. Repeated appearances count separately. Organizations and self-representation appear as printed.
LBB estimate, flow · fiscal note version S · ( ) = negative · source
Sources
Fiscal note · version S · April 25, 2025
Estimated Two-year Net Impact to General Revenue Related Funds for SB547, Committee Report 1st House, Substituted: an impact of $0 through the biennium ending August 31, 2027. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
First year · FY 2026 · $0
Probable Net Positive/(Negative) Impact to General Revenue Related Funds
LBB published estimates · flow over the stated periods.
Source snapshot 2026-10-19, Central time.
How this was graded
Analysis of text version I by claude-opus-5-5, Oct 20, 2026, against the published rubric.
Sources
Texas Senate · Filed Dec 6, 2024
05/02/2025 H Referred to Insurance: May 2 2025 2:03PM
House committee · Insurance · Final status: Died in committee
Senate committee · Health & Human Services · Committee vote 9 aye, 0 nay · Out of committee
Subjects
Health Care Providers
Insurance--Health & Accident
Insurance--Insurers & Agents
HEALTH MAINTENANCE ORGANIZATIONS
INSURANCE, TEXAS DEPARTMENT OF
Text
The text as introduced · 462 words
89R4715 DNC-D
By: Menéndez
S.B. No. 547
A BILL TO BE ENTITLED
AN ACT
relating to notice from a health benefit plan issuer to the Texas
Department of Insurance regarding a physician's or health care
provider's preauthorization exemption status.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter N, Chapter 4201, Insurance Code, is
amended by adding Section 4201.660 to read as follows:
Sec. 4201.660. EXEMPTION STATUS NOTIFICATION TO
DEPARTMENT; DATABASE AND REPORT. (a) A health maintenance
organization or insurer that uses a preauthorization process for
health care services shall provide written notice to the department
of a physician's or provider's preauthorization exemption status
under this subchapter not later than the 10th day after the date on
which the health maintenance organization or insurer:
(1) completes an evaluation of the physician or
provider as required by Section 4201.653(b) and determines whether
the physician or provider qualifies for an exemption;
(2) determines that the health maintenance
organization or insurer will continue the physician's or provider's
exemption under Section 4201.653(c);
(3) provides notice to the physician or provider of a
determination to rescind the physician's or provider's exemption;
or
(4) makes an internal appeal determination or receives
a determination from an independent review organization under
Section 4201.656 affirming or denying the health maintenance
organization's or insurer's determination to rescind the
physician's or provider's exemption.
(b) The department shall establish and maintain a database
of preauthorization exemption grants, denials, recissions, and
internal appeal and independent review determinations. On the
request of a physician or provider, the department shall provide
the physician or provider with information regarding the
physician's or provider's preauthorization exemption status with
respect to each relevant health maintenance organization or insurer
and with respect to each relevant health care service.
(c) The department shall collect and compile data
regarding:
(1) the number and timing of evaluations being
conducted by each health maintenance organization or insurer under
this subchapter;
(2) the number of internal appeals or independent
reviews conducted by or with respect to each health maintenance
organization or insurer under this subchapter;
(3) the number of exemptions granted, denied, or
rescinded by each health maintenance organization or insurer, by
provider type and health care service; and
(4) the number and outcomes of internal appeals or
independent reviews conducted by or with respect to each health
maintenance organization or insurer.
(d) The department shall annually prepare a statistical
report reflecting the data collected under Subsection (c) and make
the report available to the public on request.
SECTION 2. Section 4201.660, Insurance Code, as added by
this Act, applies only to a determination regarding a physician's
or provider's preauthorization exemption status made on or after
the effective date of this Act.
SECTION 3. This Act takes effect September 1, 2025.
Monitoring 