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Stethoscope and medical bill SB1264 created an exception for patients who knowingly want to receive nonemergency care from a doctor who is out of their health plan’s network, but the exception could cause patient confusion.

Texas’ bipartisan effort to shield patients from surprise medical bills could be weaker than lawmakers intended when it takes effect Jan. 1.

Earlier this year, lawmakers from both parties came together on legislation to protect people in state-regulated health plans from getting outrageous bills for out-of-network care. The new law, known as Senate Bill 1264, creates an arbitration process for insurers and providers to negotiate fair prices in those cases. The intention of the law is to establish those fair prices without ever involving patients.

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