For decades, surprise bills trapped patients with unexpected medical costs from out–of-network services, even though patients had no choice. Texas led the way with its surprise billing law and Congress passed a federal ban on surprise billing through the No Surprises Act. However, Congress learned from states like Texas and removed loopholes that result in abuse of the dispute resolution process.
However, the state law still applies for state-regulated insurance plans. For these plans, the incentives for abusive pricing and dispute resolution practices have not been addressed, resulting in policies that drive up the overall cost of coverage. Texas should align the state’s surprise billing rules with federal law to maximize patient protections and lower costs.