Texas Senate Passes Surprise-Billing Legislation With Arbitration

May 22, 2019

The Texas Senate passed surprise-billing legislation April 16 that aims to keep patients out of the middle of cost disputes between healthcare providers and insurance companies, according to the Texas Tribune.

Senate Bill 1264, by state Sen. Kelly Hancock, R-North Richland Hills, passed 29-2, with the dissenting votes from two physician senators.

The legislation addresses surprise medical bills that occur after a patient receives services from an out-of-network provider and is unexpectedly on the hook for the difference between what the patient’s insurer believes it should pay and what the provider believes the care is worth.

It bans providers from sending surprise bills to Texans who have state-regulated plans. It also allows providers to use arbitration for payment negotiations with insurers and prohibits them from sending patients surprise balance bills, according to a news release from Mr. Hancock’s office. The senator said the legislation would apply in medical emergencies and other situations where the patient does not have a choice of which provider they see or facility they go to.

A companion bill allowing federally regulated, self-funded health benefit plans to participate in the state insurance department’s surprise-billing mediation program also passed the state Senate.

Both bills now move to the state House.