Balance Billing Laws in Texas
Your medical billing rights and protections in Texas.
Texas enacted HB 1941 (2019), the 'Surprise Billing Protection Act,' one of the first comprehensive state laws addressing surprise medical bills. The law prohibits balance billing in emergency and non-emergency situations at in-network facilities when patients have no meaningful choice of provider, and established a first-of-its-kind state arbitration system to resolve payment disputes between providers and insurers.
Key Protections in Texas
Emergency services: Texas law prohibits balance billing for emergency services; patients pay only their in-network cost-sharing under their health plan
Non-emergency care at in-network facilities: Protected from balance billing by out-of-network providers when the patient had no choice; consent required for any out-of-network billing
Arbitration: Texas pioneered a state binding arbitration system; either party can invoke arbitration to settle payment disputes
Consent process: Providers must give patients 10 days' advance written notice of out-of-network status and estimated costs, with the option to seek an in-network provider
Filing Information
Within 180 days of receiving the bill for Texas state complaints
Additional Notes
Texas HB 1941 was a landmark law that inspired federal legislation. TDI has a dedicated Help Line: 1-800-252-3439. Self-funded employer plans are covered by the federal No Surprises Act rather than state law. Texas consumers can also consult the Texas Attorney General's Health Care Billing Dispute Help Tool.
How to File a Complaint in Texas
Gather Your Documentation
Collect your itemized medical bill, Explanation of Benefits (EOB) from your insurer, any prior authorization documents, and written communications with the provider or insurance company.
File with the State Regulator
Submit your complaint to the Texas Department of Insurance (TDI). Include all supporting documents and a clear description of the billing dispute.
File complaint with Texas Department of Insurance (TDI)File with CMS if Federal Protections Apply
If your dispute involves the No Surprises Act (emergency care or out-of-network providers at in-network facilities), you can also file directly with the Centers for Medicare & Medicaid Services.
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