Mediation and arbitration between health benefit plan issuers or administrators and out-of-network health care providers

Texas House Bill 3366, introduced in 2025 by Representative Tom Oliverson, aims to establish a structured process for resolving payment disputes between health insurance companies and out-of-network healthcare providers. The bill proposes mandatory mediation and arbitration procedures to determine fair compensation for services rendered by out-of-network providers, ensuring that both parties have a clear and equitable method to settle disagreements over payment amounts.

Supporters of HB3366 argue that the bill promotes fairness and transparency in the healthcare system by providing a clear framework for resolving payment disputes. They believe that the mediation and arbitration processes will help prevent prolonged conflicts, reduce litigation costs, and ensure that healthcare providers are fairly compensated for their services. Additionally, proponents suggest that the bill could lead to more predictable healthcare costs for patients, as it addresses the often contentious issue of out-of-network billing.

Critics of HB3366 express concerns that the bill may inadvertently favor insurance companies by allowing them to dictate terms during mediation and arbitration processes. They worry that out-of-network providers might be pressured into accepting lower payments than they would receive through traditional billing methods. Furthermore, some opponents argue that the bill could discourage healthcare providers from offering services to patients with certain insurance plans, potentially limiting patient access to necessary care.