Capitol Highlights

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Surprise billing: Waiver

AUSTIN — The Texas Department of Insurance last week adopted a rule outlining a narrow exception to the state’s new surprise billing protections relating to health care services provided on or after Jan. 1.

Senate Bill 1264, passed during the 2019 regular session of the Texas Legislature, is intended to protect consumers with state-regulated health plans — about 16% of Texans — from surprise bills in emergencies and in cases where the consumer had no choice of providers. The legislation carves out a narrow exception when a consumer chooses an outof-network doctor or provider at an in-network facility.

The Texas Department of Insurance, which has rulemaking authority, said the rule was adopted on an emergency basis, and the next step is for the rule to go through the normal rulemaking process, allowing time to accept and consider public comments.

 

 

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