Senate approves surprise medical bill protections

Published 3:00 pm Tuesday, April 23, 2019

To The Leader

AUSTIN, Texas — Patients wouldn’t have to worry about receiving bills for medical procedures they thought were covered by their insurance under a measure passed by the Senate on Tuesday.  Surprise billing happens when a person goes to a medical facility within their insurance network, only to find out later that care was provided by contracted providers who aren’t in their network.   Since these contractors bill the insurance company at out-of-network rates, the patient can find themselves responsible for hundreds or thousands of dollars in medical expenses that they thought were in-network.  What should happen, says North Richland Hills Senator Kelly Hancock, is that the insurer and health care providers should work this out between themselves, and leave the patient out of it. His bill, SB 1264, would protect patients from surprise billing while providing arbitration procedures to resolve billing disputes between providers.  Following the passage of the bill, Houston Senator Paul Bettencourt commended his colleague for his work on the bill. “People need help with this, because it’s not just the money, it’s the tremendous amount of time it takes to straighten these problems out,” he said.

Under the bill, if a patient receives care at an in-network facility, they are only responsible for the expected co-pays, deductibles and other out-of-pocket expenses they agreed to when they joined their insurance plan.   If there is a dispute between an insurer and a healthcare provider, the bill provides an arbitration system modeled after the one used by Major League Baseball. In this system, each party presents an offer to an impartial third-party arbitrator, and he or she picks the most reasonable offer.  This is intended to discourage low- or high-ball offers and incentivizes parties to move towards the middle to avoid getting far less or paying far more than they would like. The bill would only apply to state-regulated insurance plans. Another bill by Hancock, SB 1530, would allow purchasers of self-funded plans regulated at the federal level under ERISA to opt-in to currently existing mediation procedures at the Texas Department of Insurance.

Also Tuesday, the Senate gave tentative approval to a bill that would prohibit cities, counties and other local governmental entities from using public funds to hire professional lobbyists.   Edgewood Senator Bob Hall thinks it’s wrong when local governments use taxpayer money to hire lobbyists to go to Austin and fight legislation he believes will benefit those same taxpayers. “Taxpayer-funded lobbyists overwhelm the voices of citizens and elected officials, the very people we as legislators are elected to represent,” he said. His bill, SB 29, wouldn’t prevent local officials like mayors or city managers from coming to the statehouse to support or oppose the legislation.  The bill needs a final vote, likely Wednesday, to proceed to the House.

Finally, on Tuesday, the Senate approved the last two of a four-bill package from Conroe Senator Brandon Creighton that would prohibit municipalities from imposing regulations relating to benefits and other employment practices on private businesses.  He believes that these regulations stifle economic growth in Texas. Last week, the Senate passed two of his bills that would prevent cities from mandating sick leave and paid time-off policies to local businesses. Another bill passed Tuesday would also prohibit municipal regulations on scheduling requirements and overtime policies.  “If enacted, these local policies would be catastrophic to businesses large and small,” said Creighton. “Construction companies, restaurants, retail, hospitality, and many other industries would be devastated.” The final bill in the package would prohibit “ban the box” ordinances: rules preventing private employers from inquiring about past criminal history on employment applications.  These measures will also need another, final vote Wednesday.

The Senate will reconvene Tuesday, April 23 at 11 a.m.