| |
| |
|
|
A BILL TO BE ENTITLED
|
|
|
AN ACT
|
|
|
relating to eligibility for mediation of certain out-of-network |
|
|
health benefit claims. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. Section 1467.054(a), Insurance Code, is amended |
|
|
to read as follows: |
|
|
(a) Not later than the 90th day after the date an |
|
|
out-of-network provider receives an initial payment for a health |
|
|
care or medical service or supply, an [An] out-of-network provider |
|
|
or a health benefit plan issuer or administrator may request |
|
|
mandatory mediation under this subchapter. |
|
|
SECTION 2. (a) The changes in law made by this Act apply to |
|
|
a health care or medical service or supply provided: |
|
|
(1) on or after the 30th day after the effective date |
|
|
of this Act; or |
|
|
(2) before the 30th day after the effective date of |
|
|
this Act, if an out-of-network provider or health benefit plan |
|
|
issuer or administrator requests mandatory mediation under |
|
|
Subchapter B, Chapter 1467, Insurance Code, as amended by this Act, |
|
|
in relation to payment for the service or supply on or before the |
|
|
120th day after the effective date of this Act. |
|
|
(b) A health care or medical service or supply provided |
|
|
before the 30th day after the effective date of this Act to which |
|
|
Subsection (a) of this section does not apply is governed by the law |
|
|
in effect immediately before the effective date of this Act, and |
|
|
that law is continued in effect for that purpose. |
|
|
SECTION 3. This Act takes effect immediately if it receives |
|
|
a vote of two-thirds of all the members elected to each house, as |
|
|
provided by Section 39, Article III, Texas Constitution. If this |
|
|
Act does not receive the vote necessary for immediate effect, this |
|
|
Act takes effect September 1, 2025. |