Texas physicians group opposes legislation to combat surprise ER bills

Kelly Gooch - Print  | 

The Texas Medical Association has come out against proposed legislation designed to end surprise emergency room billing for most state residents with health insurance coverage, according to a Houston Chronicle report.

The association, which represents about 53,000 physicians, is urging state lawmakers to "hold health insurers accountable for the products they sell to Texans," the report says, citing a flyer  the association is taking to lawmakers' offices.

At issue is legislation introduced Feb. 28 by Kelly Hancock, R-Fort Worth, in the state Senate and Rep. Trey Martinez Fischer, D-San Antonio, in the state House.

The legislation is meant to protect patients from high, unexpected bills after receiving care from an out-of-network provider at an in-network facility.

It would leave patients out of the middle of disputes between the service provider and insurer, and it leave it up to the service provider and insurer to seek mediation, Mr. Hancock said in a news release. It would also ban providers from billing people insured through state-regulated health plans for services received at an in-network facility above their out-of-pocket expenses as defined under the insurance coverage.  The medical association placed the blame for surprise ER bills on insurers who they say severely limit networks, underpay physicians and choose to deny claims submitted appropriately, according to the report.

The association said the proposed legislation would allow insurers to "determine unilaterally what they pay for care provided out of network" and "skirt responsibility for the products they sell."

Mr. Hancock said in a statement obtained by the Chronicle: "It's a shame the association chose to take a staunch position against patient protections instead of working with us on the bill."

While the association opposes the legislation introduced by Mr. Hancock and Mr. Martinez Fischer, it said it does support two companion bills filed this session, HB 2967 in the House and SB 1591 in the Senate, that "remove the patient from these difficult situations but also hold insurers accountable for the products they sell."  


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