Patient protection against surprise billing moves forward in Texas Senate

The Texas Senate Committee on Business and Commerce approved a measure Tuesday to protect patients from surprise medical billing.

In a 7-2 vote, the closely watched bill now moves to the full Senate for a vote that could come as early as next week. A House version is also being voted on in committee Tuesday.

SB 1264, sponsored by Sen. Kelly Hancock, a Republican from suburban Fort Worth, would shield all emergency room patients from a business practice known as balance billing where they are saddled with the difference between what doctors and hospitals bill and what insurance pays. The measure would also prohibit balance billing when patients have no choice or advance knowledge of who will treat them.

Hancock’s bill, introduced in February, was merged on Monday with a similar measure by Sen. John Whitmire, a Houston Democrat. The new version now replaces the state’s mediation process for disputed medical bills with “baseball-style arbitration.” Under the new system providers and insurers submit their best and final offer to cover treatment costs and the final decision for payment is made by an arbiter based on supporting evidence.

Previously, patients in Texas had to initiate the mediation process which was a barrier for many. Under the new legislation, patients are removed completely from the fight and are only responsible for in-network rates for their out-of-pocket costs such as co-pays and deductibles.

The two dissenting votes on the committee came from Sens. Donna Campbell, R-New Braunfels, and Charles Schwertner, R-Georgetown, both physicians. Campbell said the bill failed to hold insurers accountable. Schewertner said he respected the spirit of the bill, but thought it needed more work.

The Texas Medical Association was also initially critical of Hancock’s bill but said Monday it was “cautiously” optimistic it could support the newly merged version.

Gov. Greg Abbott has previously said he supports protecting patients from surprise medical bills.