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Analysis

Texas Governor Signs Surprise Billing Legislation

By Jack O'Brien  
   June 17, 2019

Governor Greg Abbott signed the bill, which prevents surprise medical billing for patients, into law Friday.

Texas Governor Greg Abbott signed SB1264 into law Friday, a bipartisan bill that aims to eliminate surprise medical billing in the Lone Star State.

The bill, which was sponsored by Republican state Senator Kelly Hancock, prevents surprise medical billing for patients in situations where they have no choice which provider they see and establishes an arbitration process under state regulatory authority. This removes the need for patients to initiate a mediation process to dispute a surprise medical bill. 

The Texas legislature passed the bill in late May before the end of the 2019 legislative session, with Abbott signing it into law as part of his $250 billion budget for the 2020 fiscal year.

The Texas legislation is one of several proposals at the state level to combat the issue of surprise medical billing, which has frustrated healthcare consumers and drawn the attention of federal lawmakers in recent months.

Related: Texas Uses Arbitration to Take Steps Against Surprise Billing

Texas Health Association (THA) CEO Ted Shaw applauded Abbott in a statement Monday, writing that the legislation will act as a safeguard for consumers.

"Patients should never be surprised by unexpected bills for out-of-pocket costs for emergency or unplanned health care services," Shaw said.

THA urged Congress to take action at the federal level on behalf of consumers while also protecting private negotiation with limited "government interference in the market."

Related: Payers, Providers Butt Heads on Surprise Billing Solutions

At the start of next year, Washington will limit the amount an out-of-network provider can be paid by an insurer to a "commercially reasonable" amount. 

Similar to Texas, Washington is also establishing an arbitration process between insurers and providers when an agreement can't be reached when paying for covered services.

Further down the West Coast, California lawmakers are continuing to work on closing gaps within existing surprise billing laws in order to limit what providers can charge insurers for emergency care. 

Related: California Lawmakers Push To Stop Surprise ER Billing

Related: 'Network Matching' Offers Surprise Billing Solution

Jack O'Brien is the finance editor at HealthLeaders, a Simplify Compliance brand.


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