The Texas State legislature has passed a pair of bills that aim to bring an end to individuals receiving surprise medical bills when receiving care from facilities or doctors who are not part of the individuals’ insurance network, while also preventing those bills from being reported on the individual’s credit report.
Surprise medical billing has become a nationwide phenomenon, with stories of individuals who received bills for tens or hundreds of thousands of dollars after receiving emergency care. A number of states have sought to address the issue with legislation that would ban the practice of billing individuals who have insurance but are not covered by an out-of-network facility or physician.
In Texas, Senate Bill 1037 would prohibit the reporting of unpaid medical debts to a credit bureau, if the consumer “was covered by a health benefit plan at the time of the event giving rise to the collection and the collection is for an outstanding balance, after copayments, deductibles, and coinsurance, owed to an emergency care provider or a facility-based provider for an out-of-network benefit claim.”
The legislation does not exactly spell out how a facility or collection agency is supposed to know if an individual was covered at the time of the event, but that could likely be accomplished by the individual providing a copy of his or her insurance.
The legislature also passed Senate Bill 1264, which would force insurance companies and healthcare providers to work out payment on a balance bill if an individual has healthcare insurance, but is not necessarily covered by that particular facility or by a doctor or practitioner at the facility. If the insurance company and provider are unable to work out an arrangement, the account would go to a state arbitrator to make a decision on which side would foot the bill.
“We wanted to try to take the patients — get them out of the middle of it — because really it’s not their fight,” said Republican state Sen. Kelly Hancock, the bill’s author, in a published report
