HB 1818 proposes to amend the Texas Insurance Code by requiring the commissioner of insurance to conduct examinations of health maintenance organizations (HMOs) and insurers to ensure compliance with utilization review and preauthorization requirements related to healthcare services. These examinations must be conducted at least annually unless such compliance is already being reviewed through other examinations within the same year. The bill also allows the commissioner to assess a fee to cover the costs incurred for these examinations. Documentation provided for these reviews would be confidential and not subject to public disclosure.