Friday, March 29, 2024

New Law To Curb Surprise Medical Billing in Texas

photo source: dreamstime.com
photo source: dreamstime.com

AUSTIN – AARP Texas Director Bob Jackson today applauded Gov. Greg Abbott and members of the Legislature for making meaningful progress toward protecting consumers with the signing of Senate Bill 481, a measure that could significantly reduce surprise medical billing in Texas.

Senate Bill 481, sponsored by Sen. Kelly Hancock (R-North Richland Hills) and signed Monday by Governor Abbott, gives mediation rights to nearly all Texans who go into an in-network hospital but leave with out-of-network bills. The changes are effective Sept. 1. Today, mediation to address surprise medical bills is only available to people who get a bill that exceeds $1,000. SB 481 makes mediation available to those who get a bill over $500.

“The Legislature listened to Texans who are fed up with surprise medical bills after emergency room visits or when they go to hospitals in their insurance network,” said Jackson. “It’s great news that the Legislature and Governor Abbott acted this session to protect more consumers from being balance billed.”

Balance billing can occur even when a patient admitted to a hospital for surgery may have checked in advance to ensure the hospital was in-network. Often, the patient is shocked to discover that one of their treatment providers, such as an anesthesiologist, was out-of-network. In such cases, the patients’ insurance plan may cover a portion of the out-of-network charges, but the remainder – which can reach thousands of dollars — falls to the patient.

“Mediation is working well to the benefit of both patients and providers,” said Jackson. “Senate Bill 481 brings mediation to more consumers and will ease the practice of surprise medical billing in Texas.”

Besides expanding mediation rights to more consumers, SB 481 also helps guard against balance billing by specifying that assistant surgeons will be among the medical specialists whose charges will be subject to the law on balance billing.

AARP Texas was a key advocate for SB 481 with other groups, including Consumers Union, the Center for Public Policy Priorities, and the National Multiple Sclerosis Society.

2 COMMENTS

  1. I support this bill! Something needs to be done. We had a in-network doctor and in-network surgery ctr only to get a “surprise” bill of 2052.00 from the anesthesiologist. Patient bill of rights where are they? We NEVER even heard from his office prior to regarding an est of billing. Where does one take this to mediate? Thanks in advance!

  2. It does seem like it will do a lot of good for patients in Texas, because your story is not uncommon.

    Right now, the best suggestion is to contact the Texas Insurance Board, Sen. Kelly Hancock who sponosored this bill or AARP Texas who supported the bill. They should hopefully be able to point you in the right direction!

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