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 model legislation that protects patients from surprise medical bills and preserves private negotiations between hospitals and health plans. As the U.S. Congress pursues a legislative solution to surprise billing, Texas hospitals urge lawmakers to be aware of unintended consequences and protect private negotiation and limit government interference in the market.
Texas hospitals support: 1) protecting patients from surprise bills and 2) maintaining mediation as the process by which facilities and plans come to a mutually acceptable payment amount, without the interference of government rate setters.
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:
- Section by Section Analysis of Revised Lower Health Care Costs Act of 2019 (June 20, 2019)
- Revised Lower Health Care Costs Act of 2019 (June 20, 2019)
- HR 861 by Rep. Lloyd Doggett – End Surprise Billing Act of 2019 (June 2019)
- Draft bill by Sens. Lamar Alexander and Patty Murray – Lower Health Care Costs Act of 2019 (June 2019)
Resources
- 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)
- CMS Letter to State of Texas (12/22/21) | CMS
- THA Comments on Federal Requirements Related to Surprise Billing (12/6/21) | THA
- Comments on CMS Rules Implementing No Surprises Act (9/7/21) | THA
- HHS, DOL and Treasury Department Release FAQs on Transparency, No Surprises Act Regulations (8/23/21) | AHA
- Price Transparency and Surprise Billing (3/11/2021) | THA
- THA Files Amicus Brief in Case Against Molina Healthcare (Oct. 14, 2020)
- THA Comments to House Insurance Committee on Implementation of SB 1264 (Sept. 9, 2020)
- THA Comments on TDI Proposed Rules Regarding Waiving Surpise Billing Protections (Feb. 10, 2020)
- THA Comments on THHSC’s Draft Proposed Rule Regarding Surprise Billing Practices for Private Psychiatric and Crisis Stabilization Units (Feb. 10, 2020)
- TDI Surprise Billing Implementation Letter to Providers (Jan. 7, 2020)
- TMB Statement on Withdrawn SB 1264 Rules (Dec. 6, 2019)
- THA Comments on TDI Proposed Surprise Billing Rules (Oct. 18, 2019)
- U.S. House Ways & Means Chair Announces Rulemaking Process to Identify Standards for Surprise Billing Rates (Sept. 27, 2019)
- TDI Proposed Rules for New State Law Banning Surprise Medical Billing (Sept. 26, 2019)
- THA Provides Comments on TDI Development of Surprise Billing Rules (July 15, 2019)
- THA Submits Comments to U.S. House Ways & Means Committee on Surprise Billing (June 5, 2019)
- THA Feedback on Federal Legislation to End Surprise Medical Billing (May 28, 2019)
- THA Takeaways on Surprise Billing (May 2019)
- Whitepaper: A Patient-Friendly & Free Market Solution to Ending Surprise Billing (April 2019)
- THA Comments on State Surprise Billing Legislation (April 8, 2019)
