Final day for comments on implementing Texas surprise-billing law

Aug. 9 is the last day that Texas is seeking stakeholder input for rules the state insurance department needs to implement mediation and arbitration programs authorized by its surprise-billing law, according to Reform Austin, a nonprofit organization.

The law signed by Gov. Greg Abbott June 14 targets surprise bills that occur after a patient receives unplanned, out-of-network healthcare. It includes arbitration as a means to resolve out-of-network payment disputes between providers and insurers and sets limits on negotiated rates, according to Reform Austin.

Under the law, surprise medical bills are prohibited in circumstances where patients are unable to choose the provider they see or the facility they visit, said one of the bill's authors, Sen. Kelly Hancock, R-North Richland Hills. This includes medical emergencies, out-of-network care at in-network hospitals and out-of-network lab and imaging work.

The law is slated to take effect Jan. 1, but the Texas Department of Insurance has identified problems with implementation, according to Reform Austin.

A hearing was held July 29 to hear stakeholder comments regarding any rulemaking the state insurance department needs to implement for the law.

The hearing reportedly highlighted such issues as nonemergency exemptions and how providers and health plans will determine a fair rate.

Read the full Reform Austin report here.  



More articles on healthcare finance:

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Illinois enacts Medicaid overhaul aimed at transparency, decreasing claim denials
How an Illinois hospital overcame revenue cycle challenges by enhancing its EMR system

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