BILL ANALYSIS Senate Research Center S.B. 2544 By: Hancock Health & Human Services 4/11/2025 As Filed AUTHOR'S / SPONSOR'S STATEMENT OF INTENT With the passage of S.B. 1264 from the 86th Legislative Session, Texas set the national standard with the most comprehensive restrictions on surprise balance billing at the time. The federal No Surprises Act (NSA) was in large part built of the Texas law, however, a mediation lookback period for disputed medical charges was originally not included. S.B. 2544 creates a lookback period for disputed medical charges requested to go through mediation to align with the requirements for the arbitration process that S.B. 1264 created. State law currently provides an allowed lookback period of 90 days for mandatory arbitration. Certain facilities continue to take advantage of the law's lack of a lookback period. Revenue cycle management companies are submitting batches of claims in the mediation system dating back to the beginning of the law in 2020. As proposed, S.B. 2544 amends current law relating to eligibility for mediation of certain out-of-network health benefit claims. RULEMAKING AUTHORITY Rulemaking authority is expressly granted to the commissioner of insurance in SECTION 2 of this bill. SECTION BY SECTION ANALYSIS SECTION 1. Amends Section 1467.054(a), Insurance Code, to authorize an out-of-network provider or a health benefit plan issuer or administrator, not later than the 90th day after the date an out-of-network provider receives an initial payment for a health care or medical service or supply, to request mandatory mediation under Subchapter B (Mandatory Mediation for Out-of-Network Facilities) and to make a nonsubstantive change. SECTION 2. (a) Requires the commissioner of insurance, not later than the 30th day after the effective date of this Act, to adopt rules necessary to implement the changes in law made by this Act. (b) Makes application of this Act prospective. SECTION 3. Effective date: upon passage or September 1, 2025.
BILL ANALYSIS
Senate Research Center S.B. 2544
By: Hancock
Health & Human Services
4/11/2025
As Filed
Senate Research Center
S.B. 2544
By: Hancock
Health & Human Services
4/11/2025
As Filed
AUTHOR'S / SPONSOR'S STATEMENT OF INTENT
With the passage of S.B. 1264 from the 86th Legislative Session, Texas set the national standard with the most comprehensive restrictions on surprise balance billing at the time. The federal No Surprises Act (NSA) was in large part built of the Texas law, however, a mediation lookback period for disputed medical charges was originally not included.
S.B. 2544 creates a lookback period for disputed medical charges requested to go through mediation to align with the requirements for the arbitration process that S.B. 1264 created. State law currently provides an allowed lookback period of 90 days for mandatory arbitration.
Certain facilities continue to take advantage of the law's lack of a lookback period. Revenue cycle management companies are submitting batches of claims in the mediation system dating back to the beginning of the law in 2020.
As proposed, S.B. 2544 amends current law relating to eligibility for mediation of certain out-of-network health benefit claims.
RULEMAKING AUTHORITY
Rulemaking authority is expressly granted to the commissioner of insurance in SECTION 2 of this bill.
SECTION BY SECTION ANALYSIS
SECTION 1. Amends Section 1467.054(a), Insurance Code, to authorize an out-of-network provider or a health benefit plan issuer or administrator, not later than the 90th day after the date an out-of-network provider receives an initial payment for a health care or medical service or supply, to request mandatory mediation under Subchapter B (Mandatory Mediation for Out-of-Network Facilities) and to make a nonsubstantive change.
SECTION 2. (a) Requires the commissioner of insurance, not later than the 30th day after the effective date of this Act, to adopt rules necessary to implement the changes in law made by this Act.
(b) Makes application of this Act prospective.
SECTION 3. Effective date: upon passage or September 1, 2025.