The bill, S.B. No. 2544, amends Section 1467.054(a) of the Texas Insurance Code to establish a specific timeline for out-of-network providers to request mandatory mediation for health benefit claims. The new language stipulates that an out-of-network provider must make this request not later than the 90th day after receiving an initial payment for a healthcare service or supply. This change aims to clarify the mediation process and ensure timely resolution of disputes regarding out-of-network claims.

Additionally, the bill mandates that the commissioner of insurance adopt necessary rules to implement these changes within 30 days of the bill's effective date. The provisions of the bill will apply only to healthcare services provided on or after the 30th day following its effective date, while services provided before that date will continue to be governed by the previous law. The bill is set to take effect immediately upon receiving a two-thirds vote from both houses of the legislature, or on September 1, 2025, if such a vote is not achieved.

Statutes affected:
Introduced: Insurance Code 1467.054 (Insurance Code 1467)