Bill > SB2544

This bill modifies the timeline for requesting mandatory mediation in out-of-network health benefit claim disputes by changing the existing law to require that such requests must be made no later than 180 days after an out-of-network provider receives an initial payment for a health care or medical service or supply. The bill applies only to disputes regarding charges for health care services provided on or after the effective date of the act, with specific transitional provisions for existing disputes. For services provided before the effective date, providers can still request mediation under the previous law if the request is made within 120 days of the act's effective date. If mediation is not requested within that timeframe for pre-effective date services, the dispute will no longer be eligible for mediation. The bill will take effect immediately if it receives a two-thirds vote in the Texas legislature, or otherwise will take effect on September 1, 2025. This change aims to provide a clear and consistent timeframe for resolving out-of-network health benefit claim disputes, potentially streamlining the mediation process for both healthcare providers and insurance plans.

Business and Industry, Health and Social Services

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=SB2544