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Notice to Licensees Who Bill for Services: Texas Department of Insurance has Adopted Emergency Rules related to Balance Billing

Senate Bill (SB) 1264 was enacted by the 86th Texas Legislature, Regular Session. The changes to law made by the bill apply to health care and medical services or supplies provided on or after January 1, 2020. This bill provides new consumer protections against balance billing, also known as “surprise billing” by certain out-of-network providers. SB 1264 specifically authorizes regulatory agencies, like the Board, to take disciplinary action against practitioners that violate a law prohibiting balance billing. See Texas Insurance Code §752.0003(a).

Further, nurses are reminded that, pursuant to 22 Tex. Admin. Code §217.11(1)(A), all nurses are required to know and conform to the Texas Nursing Practice Act and the Board's rules and regulations, as well as all federal, state, or local laws, rules or regulations affecting the nurse's current area of nursing practice. Further, pursuant to 22 Tex. Admin. Code §217.12(11)(B), a nurse may be subject to discipline for violating an order of the Board, or carelessly or repetitively violating a state or federal law relating to the practice of vocational, registered or advanced practice nursing, or violating a state or federal narcotics or controlled substance law.

The Texas Department of Insurance has adopted emergency rules interpreting SB 1264 related to balance billing prohibitions. These rules may be found here: https://www.tdi.texas.gov/rules/2019/senate-bill-1264.html

The Texas Board of Nursing has not adopted rules related to the new balance billing prohibitions in SB 1264 at this time.