Texas 2025 - 89th Regular

Texas House Bill HB5036 Compare Versions

Version 1 (Old)

Version 2 (New)

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1	1		By: Dyson H.B. No. 5036
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4	6		A BILL TO BE ENTITLED
5	7		AN ACT
6	8		Relating to arbitration of certain out-of-network health benefit
7	9		claims.
8	10		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	11		SECTION 1. Section 1467.001(6-a), Insurance Code, is
10	12		amended to read as follows:
11	13		(6-a) "Out-of-network provider" means a diagnostic
12	14		imaging provider, emergency care provider, facility-based
13	15		provider, or laboratory service provider that is not a
14	16		participating provider for a health benefit plan. The term
15	17		includes a group of out-of-network providers identified by one of
16	18		the following:
17	19		(A) a National Provider Identification Number;
18	20		(B) a group National Provider Identification
19	21		Number;
20	22		(C) an Employer Identification Number.
21	23		SECTION 2. Section 1467.087(e), Insurance Code, is amended
22	24		to read as follows:
23	25		(e) The losing party [parties] shall [evenly split and] pay
24	26		the arbitrator's fees and expenses not later than the 30th day after
25	27		the date the arbitrator provides the parties with the written
26	28		decision.
27	29		SECTION 3. The changes in law made by this Act apply only to
28	30		a health care or medical service or supply provided on or after
29	31		January 1, 2026. A health care or medical services or supply
30	32		provided before January 1, 2026, is governed by the law as it
31	33		existed immediately before the effective date of this Act, and that
32	34		law is continued in effect for that purpose.
33	35		SECTION 4. This Act takes effect September 1, 2025.