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Relating to consumer protections against billing and limitations on information reported by consumer reporting agencies.
Estimated Two-year Net Impact to General Revenue Related Funds for SB 1264, Committee
Report 1st House, Substituted: a negative impact of ($17,682,459) through the biennium ending
August 31, 2021.
The bill would make no appropriation but could provide the legal basis for an appropriation of
funds to implement the provisions of the bill. The Texas Department of Insurance, Employees
Retirement System, Teacher Retirement System, and any other state agency subject to this Act
are required to implement a provision of this Act only if the legislature appropriates money
specifically for that purpose. If the legislature does not appropriate money specifically for that
purpose, the agencies may, but are not required to, implement a provision of this Act using other
appropriations available for that purpose.
SB 1264 would amend the Insurance Code in several significant ways. First, it would prohibit all non-network facility-based providers at network hospitals and all non-network emergency care providers from sending surprise balance bills to consumers. Second, it would require all health plan providers to pay reasonable or agreed-upon amounts to out-of-network emergency care and facility-based providers. Third, it would prohibit consumer reporting agencies to release reports relating to a collection account with a medical industry code with an outstanding balance after co-payments, deductibles, and coinsurance, owed to an emergency care provider. Fourth, it would allow providers to dispute payments through the Texas Department Insurance mediation program.
Texas Action remains neutral on SB 1264 due to conflicting principles. Consumer reports serve for more than information for credit corporations. Economic analysts and businesses are in need of reliable and accurate consumer information in order to gauge the risk to the economy and manage declining consumer demand which is often gauged through these reports. While the bill may look to protect consumers in specific situations, the unintended consequences of this bill could harm consumers in a different space.
However, surprise billing is a legitimate concern and the government serves a proper role in protecting consumers from these practices. Therefore, we remain neutral on SB 1264.