Months before it takes effect, Texas' new surprise-billing law faces an obstacle as supporters worry about an exception in the legislation, according to the Houston Chronicle.
The law, signed by Gov. Greg Abbott June 14, takes effect Jan. 1, 2020. It bans surprise medical bills in circumstances where patients are unable to choose the provider they see or the facility they visit, said one of the bill's authors, Sen. Kelly Hancock, R-North Richland Hills. This includes medical emergencies as well as out-of-network lab and imaging work.
Under the new law, balance billing is also prohibited if a patient has a scheduled or nonemergency procedure at an in-network facility and is seen by an out-of-network physician, the Chronicle reported. The law applies to residents who have insurance regulated by the Texas Department of Insurance.
But supporters are worried about an exception in the law, under which a patient has the option of waiving their billing protection on paper if they are notified before their scheduled or non-emergency procedure that an out-of-network provider will be part of their care, according to the Chronicle.
A key sticking point with the exception revolves around how much in advance non-emergency patients should be notified. The newspaper reported that supporters of the law, such as the law's authors, consumer groups and the state's insurance trade association, have suggested anywhere from three days to a week or more. However, physician and hospital groups are opposed to a state-imposed timeline.
According to the Chronicle, medical specialty organizations including the Texas Medical Association argued this summer that "to impose a particular time frame through rule making could have [an] unintended consequence on patient care," such as forcing patients to delay or cancel needed care to allow time to find a provider in their insurance company's network.
Read the full Chronicle report here.
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