Texas House Bill HB3133

Texas 2015 - 84th Regular

Caption

Relating to notice and availability of mediation for balance billing by a facility-based physician.

Impact

The implications of HB3133 are significant for both healthcare providers and patients. By mandating that facility-based physicians provide a clear notice regarding the availability of mediation in cases of out-of-network billing, the bill aims to enhance patient awareness of their options and protect them from unexpected medical costs. By potentially reducing the incidence of balance billing disputes, it could ultimately lead to better patient-provider relationships and reduce litigation related to billing conflicts.

Summary

House Bill 3133 focuses on the rights of patients who receive services from facility-based physicians and the mediation process related to balance billing. The bill amends sections of the Health and Safety Code and Insurance Code to define facility-based physicians—specifically including roles such as radiologists, anesthesiologists, pathologists, emergency department physicians, neonatologists, and assistant surgeons. It establishes a requirement for these providers to notify patients of their rights to mediation when they face substantial balance billing claims, specifically when the amount exceeds $1,000 after considering co-pays, deductibles, and coinsurance.

Contention

Notable points of contention around HB3133 could arise from concerns about enforcement and compliance with the mediation process. Advocates for the bill argue that it is essential for protecting patient rights and reducing the financial burden on patients facing high medical bills. Conversely, opponents might contend that the bill could place additional regulatory burdens on already over-taxed facilities and providers, complicating the billing processes further, especially in emergency situations where patients have little control over their choices in healthcare providers.