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After Controversy, Texas Medical Board Is No Longer Writing Rules For Surprise Bill Law

Jorge Sanhueza-Lyon

The Texas Medical Board will no longer be writing the rules for a new law outlawing surprise medical bills for some Texans. The law goes into effect Jan. 1.

During a meeting Friday morning, the board decided to relinquish its rulemaking authority after consumer advocates accused it of undermining the law.

Earlier this year, Republican and Democratic lawmakers came together to pass legislation that would shield people with state-regulated health insurance plans from getting expensive bills for out-of-network care – particularly in cases where patients cannot choose their provider.

Senate Bill 1264 creates an arbitration process for insurers and providers to negotiate fair prices for that out-of-network care without involving patients. Currently, patients can get a “surprise bill” when both sides can’t agree on a fair price.

Consumer advocates – who championed SB 1264 – began raising concerns when agencies started writing rules for the law. Specifically, they pointed to an alleged “loophole” within rules proposed by the Texas Medical Board that would have allowed providers in non-emergency situations to ask patients to agree to pay high out-of-network prices.

After news media flagged the exception, Lt. Gov. Dan Patrick released a stern statement expressing his unhappiness with the board’s proposed rules.

“After passing the strongest 'surprise billing' protections in the nation, I am not happy to learn that attempts may be being made at the Texas Medical Board to create a loophole to undermine this important law,” he said in the statement. “Members of the Texas Medical Board should be aware that the Texas Senate approves all appointments to the TMB. I believe it is unlikely the votes would be there to confirm new interim appointments or approve the reappointment of any member who votes to circumvent the intent of clearly written legislation.”

Although it is unclear what agency will take over the rulemaking process, Texans with state-regulated plans will not have to pay surprise medical bills in emergency or non-emergency situations starting next year.

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Ashley Lopez covers politics and health care. Got a tip? Email her at Follow her on Twitter @AshLopezRadio.
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