Patients with health insurance should never be surprised by unexpected out-of-pocket costs. During the 2019 legislative session, THA worked with state lawmakers to pass Senate Bill 1264, model legislation that protects patients from surprise medical bills and preserves private negotiations between hospitals and health plans. The following year, Congress passed the No Surprises Act, legislation with broadly the same aim and a similar approach to the Texas law: to resolve disputes over payment for out-of-network care without involving the patient in the dispute. The bill passed as part of the Consolidated Appropriations Act of 2021, signed into law in Dec. 2020.
Legislation
State:
- SB 1264 by Sen. Kelly Hancock – Relating to consumer protections against certain medical and health care billing by certain out-of-network providers; authorizing a fee. (June 2019)
Federal:
- Consolidated Appropriations Act of 2021 (contained the No Surprises Act; signed into law December 2020)
Resources
- Frequently Asked Questions: The No Surprises Act (Centers for Medicare & Medicaid Services)
- FAQ About Consolidated Appropriations Act, including the No Surprises Act (Department of Labor)
- The No Surprises Act’s Prohibitions on Balancing Billing | CMS
- Overview of Public Health Service (PHS) Act Provider and Facility Requirements | CMS
- Overview of Rules & Fact Sheets | CMS
- Model Texas Surprise Billing Notice / Spanish version (12/29/21) | THA
- Model Disclosure Notice Regarding Patient Protections Against Surprise Billing (12/29/21)
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