In addition to H.B. 307 (discussed in a prior post), H.B. 1566 and its companion bill, S.B. 507, propose to expand the requirement for mediation of balance bills.
Currently, Chapter 1467 of the Texas Insurance Code requires a facility-based physician to mediate balance bills upon the request of the patient if the patient is responsible to a facility-based physician, after copayments, deductibles, and coinsurance, including the amount unpaid by the administrator or insurer, for an amount greater than $500 and either (i) the facility-based physician fails to disclose projected amounts for which the patient may be responsible and the circumstances under which the enrollee would be responsible for those amounts; or (ii) the facility-based physician makes the disclosures but the amount billed is greater than the maximum amount projected in the disclosure.
Continue Reading Texas 85th Legislature (2017) Legislation Update: Out-of-network billing limitations