After authoring a bill to prevent Texas residents who are on state-regulated insurance plans from being hit with surprise medical billing, Senator Kelly Hancock was glad to see the bill moving forward. When the proposed bill becomes law on Sept. 1, 2020, insurance companies and providers would be required to participate in arbitration. A journalist from KVUE sat down and interviewed Senator Hancock about the bill and what it would mean to Texans.
Hancock’s Work on Surprise Medical Billing
Senator Hancock has worked on surprise medical billing issues for over a decade. He first became aware of this issue when a friend of his had an operation, met his co-pay, paid his deductible and then suddenly received a bill for thousands of dollars in expected payment. Ten years ago, he helped pass the first bill of its nature in Texas and has since continued the fight.
What the Bill Means to Texans
Surprise billing refers to a practice in which insured individuals believe that their insurance company has covered everything after they met their deductible and paid their co-pay and receive a bill by surprise. In these situations, the insurance company has paid the provider but not enough. The patient is then forced to pay the remaining balance. The bill would remove the patient as the middleman. If passed, the provider would not be able to go to the patient for the difference. Instead, the provider could initiate arbitration with the insurance company. An arbitrator would then help determine what the correct amount of payment should be and may order the insurance company to pay more to the provider. Whichever party is closer to the number the arbitrator determines wins the case. Senator Hancock believes that this change in approach would bring both parties – the insurance company and the provider – toward the middle and avoid lowball payments or egregious charges.
History and Current Status of the Bill
Several other people have been key in the development of the bill, including Doctor Oliverson, Senator John Whitmire and Trey Martinez Fischer. Legislators worked together piecemealing the current bill from previous versions. The bill was borne out of bipartisan cooperation and between the Senate and the House of Representatives. Many lawmakers have supported the bill.
The Senate Committee on Business and Commerce recently voted on Senate Bill 1264. Senator Hancock had previously passed similar bills, but they had less reach than the current comprehensive bill that would basically eliminate surprise medical bills for individuals who are covered by state-regulated plans. The bill has been signed into law and will take effect September 1st, 2020.
How Bill Can Impact Personal Injury Victims
When determining an appropriate settlement amount, victims must consider the medical expenses that they have already paid for and future medical expenses. The medical expense cost is a key factor in the value of the claim. By passing this proposed law, accident victims may be able to prevent settling a case only to receive an unexpected bill for services months later.
