Monitoring the Session

SB 54

bill to keep ambulance surprise bill ban past 2027

Filed

Verdict: No flags

No flagsInitial review
Sen. Judith ZaffiriniDSenate 21

Initial review · graded Nov 9, 2026 · How we grade

Caption

relating to the expiration of consumer protections against certain medical and health care billing by emergency medical services providers.

Caption from analyzed text · version I.

Summary

The ban stays until a federal law takes over.

This bill removes the September 1, 2027 end date on Texas rules that stop ground ambulance and other emergency medical services providers from balance billing patients, which means sending patients a surprise bill for the gap their health plan did not pay. It touches patients, emergency medical services providers, and several kinds of health plans, including state employee, teacher, and retiree plans. The protections now stay in force until the attorney general publishes a notice in the Texas Register that a federal law banning this kind of balance billing has taken effect.

Receipt

The receipt

90R-SB54 · 2026-11-09

SOLD BY

ITEM

relating to the expiration of consumer protections against certain medical and health care billing by emergency medical services providers.

WHAT IT DOES

The ban stays until a federal law takes over.

This bill removes the September 1, 2027 end date on Texas rules that stop ground ambulance and other emergency medical services providers from balance billing patients, which means sending patients a surprise bill for the gap their health plan did not pay. It touches patients, emergency medical services providers, and several kinds of health plans, including state employee, teacher, and retiree plans. The protections now stay in force until the attorney general publishes a notice in the Texas Register that a federal law banning this kind of balance billing has taken effect.

CHARGES

[ ] NONE FOUND

TOTAL

No fiscal note in the loaded record.

HISTORY

  1. Received by the Secretary of the Senate
  2. Filed
FILED UNDER

No verified beat found.

No flags

THANK YOU FOR CHECKING THE RECEIPT

CAMPAIGN PAID FOR BY

CAMPAIGN PAID FOR BY

Donors

Not tied to this bill.

Sources

The author's campaign account only. Own money and internal transfers are separate on the member page.

Derived itemized flow · Jul 1, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Carlos M. Zaffirini Jr$110,000.00
Killam Development Ltd.$72,700.00

Killam Development Ltd.

$72,700.00

Cash
$10,000.00
Paid by others
$62,700.00
Total
$72,700.00
advertising $33,000.00media $29,700.00

Also funds 3 other sitting lawmakers.

Derived recipient stock · Dec 9, 2024 to Sep 28, 2026. State data as of Nov 4, 2026.

Name match, not a verified identity: normalized filed name and state.

Sources

Derived itemized flow · Dec 16, 2025 to Aug 20, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101011018, 101057658.

Texas Trial Lawyers Association PAC$60,000.00

Texas Trial Lawyers Association PAC

$60,000.00

Cash
$60,000.00
Paid by others
$0.00
Total
$60,000.00

Also funds 137 other sitting lawmakers.

Derived recipient stock · Jul 24, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Nov 11, 2024 to Aug 31, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 100959783, 100987492, 101011018, 101035338, 101057658.

Money

Missing data does not establish zero giving. Display amounts are rounded.

×

Killam Development Ltd.

$72,700.00

Cash
$10,000.00
Paid by others
$62,700.00
Total
$72,700.00
advertising $33,000.00media $29,700.00

Also funds 3 other sitting lawmakers.

Derived recipient stock · Dec 9, 2024 to Sep 28, 2026. State data as of Nov 4, 2026.

Name match, not a verified identity: normalized filed name and state.

Sources

Derived itemized flow · Dec 16, 2025 to Aug 20, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101011018, 101057658.

×

Texas Trial Lawyers Association PAC

$60,000.00

Cash
$60,000.00
Paid by others
$0.00
Total
$60,000.00

Also funds 137 other sitting lawmakers.

Derived recipient stock · Jul 24, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Nov 11, 2024 to Aug 31, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 100959783, 100987492, 101011018, 101035338, 101057658.

Votes

No floor vote loaded for this bill.

Fiscal

No fiscal note in the loaded record.

How this was graded

Analysis of text version I by a super-expensive superintelligence, Nov 9, 2026, against the published rubric.

Sources

Texas Senate · Filed Nov 9, 2026

11/09/2026 S Filed

Texas Legislature Online · Introduced

Data snapshot Nov 10, 2026 at 2:39 AM CST. Grades, charges, quotes and corrections follow the published record.

Subjects

Consumer Protection

Health Care Providers

Health--Emergency Services & Personnel

Insurance--Health & Accident

AMBULANCES

ATTORNEY GENERAL

STATE HEALTH SERVICES, DEPARTMENT OF

Text

The text as introduced · 680 words

90R3956 SCL-D

By: Zaffirini
S.B. No. 54

A BILL TO BE ENTITLED

AN ACT

relating to the expiration of consumer protections against certain

medical and health care billing by emergency medical services

providers.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. (a) Section 773.061, Health and Safety Code, is

amended by adding Subsection (a-2) to read as follows:

(a-2) Subsection (a-1) and this subsection expire on the

first day after the date the office of the attorney general

publishes in the Texas Register a finding that a federal law has

taken effect that prohibits out-of-network providers that are

emergency medical services providers, as that term is defined by

Section 1275.054, Insurance Code, from engaging in balance billing,

as defined by Section 1456.001, Insurance Code.

(b) The expiration of Section 773.061(a-1), Health and

Safety Code, as provided by Section 773.061(a-2), Health and Safety

Code, as added by this Act, does not affect the authority of the

Department of State Health Services to revoke, suspend, or refuse

to renew a license or certificate of a provider based on an act or

omission that occurs before that expiration.

SECTION 2. Section 38.006(b), Insurance Code, is amended to

read as follows:

(b) This section expires on the first day after the date the

office of the attorney general publishes in the Texas Register a

finding that a federal law has taken effect that prohibits

out-of-network providers that are emergency medical services

providers, as that term is defined by Section 1275.054, from

engaging in balance billing, as defined by Section 1456.001

[ September 1, 2027 ].

SECTION 3. Section 1271.159(g), Insurance Code, is amended

to read as follows:

(g) This section expires on the first day after the date the

office of the attorney general publishes in the Texas Register a

finding that a federal law has taken effect that prohibits

non-network emergency medical services providers from engaging in

balance billing, as defined by Section 1456.001 [ September 1,

2027 ].

SECTION 4. Section 1275.054(f), Insurance Code, is amended

to read as follows:

(f) This section expires on the first day after the date the

office of the attorney general publishes in the Texas Register a

finding that a federal law has taken effect that prohibits

out-of-network providers that are emergency medical services

providers from engaging in balance billing, as defined by Section

1456.001 [ September 1, 2027 ].

SECTION 5. Section 1301.166(g), Insurance Code, is amended

to read as follows:

(g) This section expires on the first day after the date the

office of the attorney general publishes in the Texas Register a

finding that a federal law has taken effect that prohibits

out-of-network providers that are emergency medical services

providers from engaging in balance billing, as defined by Section

1456.001 [ September 1, 2027 ].

SECTION 6. Section 1551.231(f), Insurance Code, is amended

to read as follows:

(f) This section expires on the first day after the date the

office of the attorney general publishes in the Texas Register a

finding that a federal law has taken effect that prohibits

out-of-network providers that are emergency medical services

providers from engaging in balance billing, as defined by Section

1456.001 [ September 1, 2027 ].

SECTION 7. Section 1575.174(f), Insurance Code, is amended

to read as follows:

(f) This section expires on the first day after the date the

office of the attorney general publishes in the Texas Register a

finding that a federal law has taken effect that prohibits

out-of-network providers that are emergency medical services

providers from engaging in balance billing, as defined by Section

1456.001 [ September 1, 2027 ].

SECTION 8. Section 1579.112(f), Insurance Code, is amended

to read as follows:

(f) This section expires on the first day after the date the

office of the attorney general publishes in the Texas Register a

finding that a federal law has taken effect that prohibits

out-of-network providers that are emergency medical services

providers from engaging in balance billing, as defined by Section

1456.001 [ September 1, 2027 ].

SECTION 9. This Act takes effect September 1, 2027.