The bill, H.B. No. 3366, aims to enhance the mediation and arbitration processes between health benefit plan issuers or administrators and out-of-network health care providers. Key amendments include the requirement that both parties involved in mediation must have representatives with the authority to reach binding agreements, ensuring that health benefit plan issuers or administrators can commit to payment amounts agreed upon during mediation. Additionally, health benefit plan issuers or administrators are mandated to provide complete contact information to the mediator promptly after their appointment to facilitate the mediation process.

Furthermore, the bill introduces a provision allowing mediators to compel arbitration if no agreement is reached during mediation and if a party is found to have not participated in good faith. It also stipulates that the costs associated with arbitration will be shared equally between the parties, with a cap on fees determined by the commissioner to ensure fair compensation for arbitrators. The changes will take effect for services provided on or after January 1, 2026, while services rendered before this date will continue to be governed by existing laws. The bill is set to take effect on September 1, 2025.

Statutes affected:
Introduced: Insurance Code 1467.051, Insurance Code 1467.054, Insurance Code 1467.087 (Insurance Code 1467)