Texas House bill by Rep. Bonnen amends health care preauthorization and utilization review requirements

Passed bill authored by State Rep. Greg Bonnen seeks to amend preauthorization requirements for health care services and ensure utilization reviews are directed by licensed physicians in Texas, according to the Texas Legislature website.

In the House, 60 Democrats and 56 Republicans voted in favor of the bill, while 26 Republicans opposed it.

Meanwhile, in the Senate, 10 Democrats and 20 Republicans voted in favor, while one Democrat voted against it.

Greg Bonnen introduced the bill in the Texas House on Wednesday, March 5, during the 89th regular legislative session.

Bonnen graduated from Texas A&M University with a BS.

Bonnen, a Republican, was elected to the Texas State House in 2013 to represent the state’s 24th House district, replacing previous state representative Larry Taylor.

According to the Texas Legislature, the bill’s official text was summarized as follows: ‘Relating to health benefit plan preauthorization requirements for certain health care services and the direction of utilization review by physicians’.

The following is our breakdown, based on the actual bill text, and may include interpretation to clarify its provisions.

In essence, this bill aims to amend preauthorization requirements for health care services under health benefit plans and to ensure that utilization reviews are directed by licensed physicians in Texas. It requires a utilization review to be conducted under a physician’s direction, prohibits it based on non-medical criteria, and allows the Texas Medical Board to investigate arbitrary reviews. Health organizations cannot require preauthorization if 90% or more of requests by a provider were previously approved. It establishes criteria for rescinding exemptions and mandates an annual report submission by insurers on exemptions granted or denied. The bill, set to take effect Sept. 1, 2025, specifies that changes only apply to reviews conducted after this date.

The bill was co-authored by Rep. Robert Guerra (Democrat – District 41), Rep. Will Metcalf (Republican – District 16), and Rep. Tom Oliverson (Republican – District 130), along with four other authors.

The bill received its final legislative approval on Tuesday, May 27, and was signed into law by Gov. Greg Abbott on Friday, June 20.

Bills in Texas go through a multi-step legislative process, including committee review, debates, and votes in both chambers before reaching a final decision. Each session, there are typically thousands of bills introduced, but only a portion successfully navigate the process to become law.

You can read more about the bills and other measures here.