TITLE: Relating to arbitration of certain out-of-network health benefit claims.

SUMMARY: Relating to arbitration of certain out-of-network health benefit claims.

FULL TEXT:
AN ACT Relating to arbitration of certain out-of-network health benefit claims. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Section 1467.001(6-a), Insurance Code, is amended to read as follows: (6-a) "Out-of-network provider" means a diagnostic imaging provider, emergency care provider, facility-based provider, or laboratory service provider that is not a participating provider for a health benefit plan. The term includes a group of out-of-network providers identified by one of the following: (A) a National Provider Identification Number; (B) a group National Provider Identification Number; (C) an Employer Identification Number. SECTION 2. Section 1467.087(e), Insurance Code, is amended to read as follows: (e) The losing party [parties] shall [evenly split and] pay the arbitrator's fees and expenses not later than the 30th day after the date the arbitrator provides the parties with the written decision. SECTION 3. The changes in law made by this Act apply only to a health care or medical service or supply provided on or after January 1, 2026. A health care or medical services or supply provided before January 1, 2026, is governed by the law as it existed immediately before the effective date of this Act, and that law is continued in effect for that purpose. SECTION 4. This Act takes effect September 1, 2025.