As of the signing of Senate Bill 1264 on June 14th, Texas is now among a slew of states that have consumer protection laws in place for Surprise billing.
The bill will be effective as of September 2019 and will focus on getting rid of surprise billing for some specific health plans as well as the mandatory mediation requests and also by implementing limitations on surprise billing information being reported by reporting agencies.
Under the new bill, mediation will not require involvement from the patient at all but instead it will be between the health plan and the provider and it will be managed by an impartial mediator. All types of providers can request help with mediation from the state and the cost of that mediator will be then split between the respective parties. It is then the responsibility of the state to notify the affected parties that are so named in the mediation request.
As per the legislation, mediation must be started within 180 days of the request being submitted. The new bill also requests health plans to pay any emergency care given by any out of network providers at an established rate that the organization considers reasonable.