Texas Lawmakers Pass Three Patient Protection Bills Aimed at Surprise Billing

June 2019 ~

The Texas legislature has passed three patient protection bills aimed at Medicaid managed care and safeguarding against surprise medical bills.

Senate Bill 1264 – would create an arbitration process that removes the patient from the billing dispute.

Senate Bill 1530 – a companion bill which would allow federally regulated self-funding health benefit plans to opt into the existing Texas Department of Insurance (TDI) surprise billing mediation plan.

House Bill 2041 – requires a freestanding emergency rooms to give patients a printed-out disclosure in English and Spanish that lists the in-network health plans and the average price a patient may be charged for a procedure, including facility fees. Patients can choose whether to sign it. Under the bill, freestanding emergency rooms will also be barred from advertising that it “takes” or “accepts” certain insurers or health plans if the facility is not an in-network provider.

The bills also include the creation of an “external medical reviewer” assigned to review coverage denials by Medicaid plans as well as additional transparency and oversight measures.

Author of two of the reform bills, Senator Charles Perry, said “Medically fragile children and their families will see much-needed improvements to coordination of care through the passage of these bills,” Perry said. “Families will now be able to spend more time caring for their child and less time navigating a complicated health care system.”

“There have been a lot of behind-the-scenes meetings to make sure our changes were going to have a real and immediate positive impact on these children,” Perry added.

Senate Health and Human Services Committee Chairperson, Senator Lois Kolkhorst commented, “I’m proud of the bipartisan work we did on this issue, especially the significant innovations for managed care that I added to the legislation to improve accountability and efficiencies. We made changes to the system that were truly needed to help our most fragile Texans and the families who care for them.”

The bills now head to the Governor’s desk for signature.

Source(s): Dallas Morning News; Texas Tribune; Moody College of Communication, University of Texas Austin;