TX · last verified 2026-05-12
Texas — NSA dispute pathway
Ground-ambulance balance-billing law
NO STATE LAW
—
State IDR pathway
STATE IDR AVAILABLE
Tex. Ins. Code §1467
ERISA self-funded plans
STATE DOI HAS NO JURISDICTION
Self-funded plans always route to Federal IDR + DOL/EBSA enforcement, regardless of state.
How Texas fits the NSA picture
Texas SB-1264 (2019) protects against balance billing for emergency and certain OON services at INN facilities, but does NOT cover ground ambulance. ERISA self-funded plans are not covered by state law (federal preemption); the federal NSA applies via Federal IDR.
Free first step — CMS No Surprises Help Desk
The CMS-administered consumer complaint pathway. Free, federal, and the recommended first action for any balance-billed insured patient. You have 90 calendar days from when you knew or should have known of the NSA violation to file.