Texas Senate Bill SB1306

Texas 2023 - 88th Regular

• Filed: 2/28/23

Caption

Relating to the application of balance billing prohibitions and out-of-network dispute resolution procedures to certain self-insured or self-funded employee welfare benefit plans.

Impact

The implementation of SB1306 is expected to impact state laws related to healthcare billing practices considerably. By extending protections against balance billing to self-funded plans, the bill will create a more consistent standard across different health benefit plans. This is crucial for employees who often face confusing billing scenarios when accessing care from out-of-network providers, thereby promoting fair treatment in medical billing and potential savings for individuals.

Summary

SB1306 addresses the application of balance billing prohibitions and procedures for out-of-network dispute resolution specifically for certain self-insured or self-funded employee welfare benefit plans. This bill is significant as it aims to protect employees covered under these plans from unforeseen medical expenses that may arise when receiving care outside their healthcare network, which can lead to considerable financial burdens due to balance billing practices.

Sentiment

The sentiment surrounding SB1306 appears to be generally positive among consumer advocacy groups and some legislators who advocate for greater protections for employees against balance billing practices. Supporters argue that this legislation is a necessary step in safeguarding consumers in the complex healthcare system. However, there may be some contention from insurers and employers who could raise concerns about increased administrative burdens and costs if self-funded plans must adhere to more stringent regulations.

Contention

One notable point of contention in the discussion of SB1306 pertains to the scope of the legislation and its implications for self-insured plans. Critics are concerned that while the bill aims to protect employees, it could inadvertently lead to increased premiums for these plans or push employers away from offering such benefits. Additionally, the requirement for plan sponsors to choose to apply these provisions raises questions about the overall effectiveness of the law, as some employers may opt-out of these new regulations, thus leaving a segment of employees without the intended protections.

Texas Constitutional Statutes Affected

Insurance Code

• Chapter 1275. Balance Billing Prohibitions And Out-of-network Claim Dispute Resolution For Certain Plans
  • Section: 002