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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) Not later than the 30th day after the |
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effective date of this Act, the commissioner of insurance shall |
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adopt rules necessary to implement the changes in law made by this |
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Act. |
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(b) The changes in law made by this Act apply only to a |
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health care or medical service or supply provided on or after the |
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30th day after the effective date of this Act. A health care or |
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medical service or supply provided before that date is governed by |
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the law in effect immediately before the effective date of this Act, |
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and that law is continued in effect for that purpose. |
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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. |