Texan lawmakers introduce legislation to end surprise billing for most insured Texans


Texan lawmakers have introduced legislation meant to end surprise billing for most state residents with health insurance coverage.

The legislation, introduced by state Sen. Kelly Hancock, R-Fort Worth, and state Rep. Trey Martinez Fischer, D-San Antonio, is meant to protect patients from high, unexpected bills after receiving care from an out-of-network provider at an in-network facility.

Texas already has a mediation program that helps patients with surprise medical bills. It works with the health insurance company and the health provider to arrive at an agreement on the amount charged by the provider, the amount paid by the insurer to the provider and the amount paid by the patient.

Texans still receive unexpected surprise medical bills annually. The new legislation would leave patients out of the middle of disputes between the service provider and insurer. It will leave it up to the service provider and insurer to seek mediation.

It would also ban providers from billing people insured through state-regulated health plans for services received at an in-network facility above their out-of-pocket expenses as defined under the insurance coverage.

The legislation includes an opt-in provision for people under federally regulated, self-funded Employee Retirement Income Security Act health plans.