Rule Changes Would Amend Mediation, Add Assistant Surgeons to Covered Physicians List

The Texas Department of Insurance has proposed some administrative changes to regulations governing out-of-network, claim-dispute resolutions. The agency must amend the Texas Administrative Code to conform to Senate Bill 481, which was passed last year and was made effective Sept. 1. SB 481 added assistant surgeons to the list of covered physicians and lowered the amount for mediation from $1,000 to $500. When services are rendered to a patient by a nonpreferred facility-based physician and the difference between the allowed amount and the billed charge is at least $500, the insurer must inf...