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Texas Legislature Considers Measure that Would Require Out-of-Network Emergency Room Providers to Arbitrate Payment Claims

by Beth Graham
March 2015

Disputing Blog by Karl Bayer, Victoria VanBuren, and Holly Hayes

Beth Graham

A bill seeking to establish an arbitration process designed to protect patients who are treated by an out-of-network provider during an emergency room visit from being hit with hefty medical charges is currently before the Texas Legislature. House Bill 1638, “Relating to nonpreferred provider claims under a preferred provider benefit plan related to emergency care,” was introduced by Representative Smithee and filed on February 19, 2015. An accompanying proposal was introduced in the Texas Senate on March 12th by Senator Taylor of Galveston. The proposed legislation would require out-of-network emergency room physicians to arbitrate their payment claims directly with a patient’s insurance company. On March 9th, HB 1638 was referred to the House Committee on Insurance.

A similar proposal that would allow patients to request mediation over freestanding emergency room care charges is also being considered by Texas lawmakers. HB 3475, “Relating to health care information provided by and notice of facility fees charged by certain freestanding emergency medical care facilities and the availability of mediation,” was recently referred to the House Committee on Public Health. Its companion bill, SB 425, is now being considered by the Senate Committee on Business & Commerce.

You may monitor the bills as they move through the Texas Legislature here.

Biography


Beth Graham received a J.D. from the University of Nebraska College of Law in 2004 and a M.A. in Information Science and Learning Technologies from the University of Missouri in 2006. She also holds a B.S. in Public Administration from the University of Nebraska-Omaha. She is licensed to practice law in Texas and the District of Columbia.



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