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