The bill — by state Sens. Kelly Hancock, R-North Richland Hills, and John Whitmire, D-Houston, as well as state Reps. Tom Oliverson, R-Cypress, and Trey Martinez Fischer, D-San Antonio — cleared the state Senate in April and the state House in May.
The law targets surprise bills that occur after a patient receives unplanned out-of-network healthcare. It also allows providers to use arbitration for payment negotiations with insurers and offers Texas officials regulatory authority over that arbitration.
Under the new law, surprise medical bills are prohibited in circumstances where patients are unable to choose the provider they see or the facility they visit, according to Mr. Hancock. This includes medical emergencies, out-of-network care at in-network hospitals and out-of-network lab and imaging work.
The surprise-billing law does not apply to patients with federally regulated health plans.
“Texas hospitals applaud Gov. Abbott and legislators for working with stakeholders to create a model for the nation on how to protect consumers while avoiding increased healthcare costs or limiting access to care,” said Ted Shaw, president and CEO of the Texas Hospital Association, in a news release. “Patients should never be surprised by unexpected bills for out-of-pocket costs for emergency or unplanned health care services.”
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