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Bill

HB 3366

Relating to mediation and arbitration between health benefit plan issuers or administrators and out-of-network health care providers.

89th Legislature (2025) Introduced by Tom Oliverson

Texas HB 3366 creates mediation and arbitration procedures for resolving payment disputes between health insurers and out-of-network providers to reduce surprise billing conflicts.

Referred to Insurance
#consumerprotection(i0080) #healthcareproviders(i0387) #insurance--health&accident(i0422) #mediation #disputeresolution #&arbitration(s8683)
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Bill Summary · HB 3366

Legislative bill overview

HB 3366 establishes mediation and arbitration procedures for disputes between health insurance plan issuers/administrators and out-of-network healthcare providers regarding payment rates and claim denials. The bill creates a structured process for resolving these conflicts outside of litigation, likely specifying timelines, procedures, and binding authority for neutral third parties.

Why is this important

Out-of-network billing disputes frequently result in surprise medical bills for patients caught between insurers and providers. This bill addresses a significant consumer protection issue by creating an alternative dispute resolution mechanism that could reduce litigation costs, speed up claim resolution, and potentially lower unexpected patient expenses. The outcome affects healthcare affordability and access to emergency or specialty care.

Potential points of contention

  • Arbitration binding authority: Whether arbitration decisions should be binding on both parties or merely advisory could significantly impact insurers' compliance incentives and providers' willingness to participate
  • Cost allocation: Disagreement over who pays for mediation/arbitration services—costs could be passed to consumers through premiums or absorbed by providers, affecting market dynamics
  • Scope limitations: The bill's applicability to emergency care, specific provider types, or plan categories may create gaps; providers/insurers may dispute which disputes qualify for the process

Compiled from official sources — confirm details with the bill’s official record.

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