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Committee debates shifting arbitration costs in out‑of‑network payment disputes
Summary
Senate Bill 2805 would change Texas’ arbitration process for out‑of‑network health‑care payment disputes by clarifying provider identifiers and requiring the losing party to pay arbitration fees; supporters say it encourages fair negotiations, opponents warn it undermines prior negotiated balance‑billing framework.
Senate Bill 2805, introduced by Sen. Hagenbuch, drew significant committee discussion as members considered changes to the arbitration process used to resolve payment disputes between health plans and out‑of‑network providers for emergency care and diagnostic services.
What the bill would change: The bill clarifies the statutory definition of “out‑of‑network provider” by listing standard group identifiers (for example, group NPI and employer identification number) to reduce administrative ambiguity. It also alters the fee structure for the Texas Department of Insurance arbitration process by requiring the “losing party” to pay the full cost of arbitration rather…
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