Bill > SB701

This bill modifies Texas insurance law to address billing disputes between health benefit plan issuers and out-of-network medical facilities by establishing clearer rules for mediation and arbitration. The bill defines "bad faith participation" in mediation as failing to provide material facts necessary for meaningful negotiation or not sending a representative authorized to negotiate. If a party engages in bad faith during mediation, the other party can request arbitration, with the out-of-network facility being treated as an out-of-network provider during the arbitration process. The Texas insurance department will be responsible for selecting an arbitrator who must make a determination within 30 days of receiving necessary information. Once the arbitrator provides a written decision, the health benefit plan issuer must pay the out-of-network facility any additional amount required to satisfy the award within 30 days. These changes will apply only to health care claims for services provided on or after January 1, 2026, and the act will take effect on September 1, 2025. The bill aims to create a more structured and fair process for resolving billing disputes between healthcare providers and insurance companies.

Health and Social Services

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=SB701