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

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by Beth Graham

Friday, Mar 20, 2015


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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.

Photo credit: StuSeeger / Foter / CC BY

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About Beth Graham

Beth Graham earned a Master of Arts in Information Science and Learning Technologies from the University of Missouri-Columbia, and a Juris Doctor from the University of Nebraska College of Law, where she was an Eastman Memorial Law Scholar. Beth is licensed to practice law in Texas and the District of Columbia. She is also a member of the Texas Bar College and holds CIPP/US, CIPP/E, and CIPM certifications from the International Association of Privacy Professionals.

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About Disputing

Disputing is published by Karl Bayer, a dispute resolution expert based in Austin, Texas. Articles published on Disputing aim to provide original insight and commentary around issues related to arbitration, mediation and the alternative dispute resolution industry.

To learn more about Karl and his team, or to schedule a mediation or arbitration with Karl’s live scheduling calendar, visit www.karlbayer.com.

About Disputing

Disputing is published by Karl Bayer, a dispute resolution expert based in Austin, Texas. Articles published on Disputing aim to provide original insight and commentary around issues related to arbitration, mediation and the alternative dispute resolution industry.

To learn more about Karl and his team, or to schedule a mediation or arbitration with Karl’s live scheduling calendar, visit www.karlbayer.com.

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