SB 926 Texas Senate · 89th Legislature (2025)

Relating to certain practices of health benefit plan issuers to encourage the use of certain physicians and health care providers and rank physicians.

SB 926 regulates how health insurance plans (health maintenance organizations) can incentivize patients to use specific doctors. It allows plans to use modified deductibles, copayments, or tiered networks to encourage enrollment with certain providers, but requires them to act in the patient's best interest (a "fiduciary duty"). The bill prohibits plans from steering patients toward doctors they control or are affiliated with, mandates that recommended providers meet quality standards, and bans misleading claims about provider quality or costs. These rules apply directly to health insurers and their enrollees (patients) in Texas, effective September 1, 2025.

Issues: ✓ Healthcare

Bill status signed all 5 stages cleared

Introduction

Jan 2025

Committee Review

Apr 2025

Senate Passage

May 2025

House Passage

Jun 2025

Signed into Law

Jun 2025

Introduced Jan 24, 2025 Signed Jun 20, 2025

Maddy AI version diff · 2 comparisons

What changed between versions

Engrossed → Enrolled · 5 edits · Jun 20, 2025

MODERATE

This bill was finalized in its enrolled version, adding new provisions to the Texas Insurance Code that regulate how health plans can incentivize or rank physicians. The changes expand protections for physicians by requiring transparency in ranking systems, mandating quality-focused standards, and establishing a formal dispute process for physicians who believe their rankings are inaccurate. These provisions aim to prevent health plans from unfairly steering patients away from certain doctors based solely on cost or unreliable data.

Scope change

The bill's scope was expanded to include new requirements for physician ranking systems and expanded protections for physicians under existing incentive provisions. The bill now applies to all health benefit plan issuers, including subsidiaries and affiliates, and adds specific rules about how rankings must be developed and disclosed.

REQUIREMENT

Added new Section 1460.003(a-1) requiring health plans to remedy discrepancies or false information in physician rankings within 30 days of receiving a physician's complaint.

Added new Section 1460.005(d) defining 'national medical specialty society' as an organization with majority physician membership representing a specific specialty and represented in the AMA.

Modified Section 1460.003(a) to require that ranking standards be developed by designated organizations and that physicians receive 45 days' notice before rankings are released.

Added new requirements for dispute resolution processes, including written communications of outcomes and opportunities for physicians to dispute rankings before publication.

ENFORCEMENT

Added new Section 1460.007(c) allowing the commissioner to prohibit ranking systems for 12 consecutive months if the issuer engages in a pattern of discrepancies or violations.

Floor votes · House May 28, 2025

How they voted

This bill passed the Senate by voice vote (no roll call recorded).

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Amendments

Jun 20, 2025

Signed into law

Signed by the Governor

executive

Jun 1, 2025

Lower · Passed

Signed in the House

lower

May 30, 2025

Upper · Passed

Signed in the Senate

upper

May 28, 2025

Upper · Passed

House passage reported

upper

May 28, 2025

Lower · Passed

Passed

lower

Apr 29, 2025

Lower · Passed

Committee report sent to Calendars

lower

Apr 29, 2025

Lower · Passed

Committee report distributed

lower

Apr 23, 2025

Lower · Passed

Reported favorably w/o amendment(s)

lower

Apr 22, 2025

Committee

Referred to Insurance

lower

Apr 22, 2025

Introduced

Read first time

lower

Apr 17, 2025

Introduced

Received from the Senate

lower

Apr 16, 2025

Upper · Passed

Passed

upper

Apr 16, 2025

Upper · Passed

Passed to engrossment as amended

upper

Apr 16, 2025

Upper · Passed

Amended

upper

Apr 16, 2025

Introduced

Amendment(s) offered

upper

Apr 14, 2025

Upper · Passed

Committee report printed and distributed

upper

Apr 14, 2025

Upper · Passed

Reported favorably as substituted

upper

Apr 10, 2025

Upper · Passed

Vote taken in committee

upper

Apr 1, 2025

Upper · Passed

Left pending in committee

upper

Apr 1, 2025

Upper · Passed

Testimony taken in committee

upper

Feb 13, 2025

Committee

Referred to Health & Human Services

upper

Feb 13, 2025

Introduced

Read first time

upper

2 primary · 1 co-sponsor