Texas Balance Billing Law To Take Effect September 1

The bill expands a patient’s ability to mediate their claims with the insurance companies and sets new guidelines for mediation………………….

Texas balance billing law to take effect Sept. 1

Written by Kelly Gooch | August 16, 2017 |

Texas legislation targeting balance billing will soon be implemented across the state, reports KWTX.

Senate Bill 507signed by Republican Gov. Greg Abbott in May, is scheduled to take effect Sept. 1. The bill “expand[s] a patient’s ability to mediate their claims with the insurance companies and set[s] new guidelines for mediation,” according to the report.

Under the bill, mediation protections are expanded for consumers with preferred provider organization plans to all out-of-network emergency providers, according to the Texas Association of Health Plans. This includes freestanding emergency rooms as well as out-of-network providers at in-network facilities. Prior Texas legislation only made mediation available to consumers balanced billed by radiologists, anesthesiologists, pathologists, emergency room physicians, neonatologists and assistant surgeons.

In addition to the balance billing legislation, state Senate Bill 680 is also slated to take effect Sept. 1. According to the report, this bill “allows physicians to override an insurance company’s protocols when prescribing specific medications for a patient.”