Texas Poised To Pass Surprise Medical Bill Law

Texas may be passing a surprise medical bill law that could help protect patients from unexpected bills after receiving medical treatment.

Texas Surprise Medical Bill Law

According to the Houston Chronicle, a new law will soon be heading to the governor’s office to be officially signed into law, providing protections for consumers overwhelmed by surprise medical bills. After over a decade of fighting for consumer rights, the bill will reportedly go into effect on Jan. 1, 2020.

On May 23, Texas governor Greg Abbott tweeted, “It’s gonna happen!” in reference to the surprise medical bill law. State senator Kelly Hancock also confirmed, “I think we got there.”

Under the bill, doctors will not be able to charge emergency room patients for any portion of their treatment that their insurance doesn’t cover. This will effectively do away with the practice of balance billing in emergency room settings, allowing patients to receive life saving care without worrying about the hit to their wallets.

The Trump administration is reportedly calling for similar laws to be passed on a national scale. NPR reports that the House has unofficially proposed the “No Surprises Act” which would curb out of network bills for emergency services.

Surprise Medical Bills Overview

Surprise medical bills can occur in a variety of situations and may have a variety of contributing factors.

In some cases, patients are surprised to be billed for emergency or specialty services at an out of network cost even if they received treatment at an in network hospital. This may occur if an emergency department is contracted and staffed by an outside company.

Some specialty medical providers such as radiologists, anesthesiologists, pathologist, and others may bill at out of network rates because they simply consult for the hospital or are an outside contractor. In either situation, this can result in thousands of dollars in unexpected medical charges.

Another cause of surprise medical bills is the practice of “balance billing.” According to the Wall Street Journal, this refers to when a doctor or hospital bills an insurance company but they do not cover the full cost of treatment. Whatever balance is leftover is then charged to the patient.

Some patients may experience both issues. They may seek medical treatment, be surprised at out of network rates, and then be forced to pay the remaining balance for their treatment after their insurance company pays only a small part of the bill.

Recently, the issue of preventative care has started to result in surprise medical bills. Some healthcare plans offered through companies offer to pay for the full cost of preventative care.

This includes physicals, colonoscopies, mammograms, and other care that helps employees stay healthy long term. However, some patients are surprised with a bill when their screening or tests are not fully covered as promised.

In some instances, surprise medical bills are the result of unlawful billing practices such as upcoding. In these instances, a hospital may bill treatment as separate services in order to maximize the amount they can charge. In more severe cases, a patient may be charged for services they did not receive.

Join a Free Surprise Medical Bill Class Action Lawsuit Investigation

If you were hit with a surprise medical bill from an out-of-network doctor at an in-network hospital, you may be entitled to compensation.

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This article is not legal advice. It is presented 
for informational purposes only.