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Bill to Protect Texas Patients, Target Deceptive Freestanding ER Practices in Texas Passes House

Thursday, May 2, 2019  
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FOR IMMEDIATE RELEASE

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May 2, 2019

John Ford, jford@tahp.org

 

 

Bill to Protect Texas Patients, Target Deceptive Freestanding ER Practices in Texas Passes House, Heads to Senate

Nearly 80% of Texas freestanding ERs say they “take” or “accept” insurance but are not in network with any major health plan

AUSTIN—New legislation that would prevent Texas freestanding emergency rooms (FSERs) from using confusing language and deceptive advertising passed the Texas House today by a vote of 135 - 4. The bill seeks to shine a light on those FSERs that continue to intentionally mislead Texas patients and take advantage of them financially in the form of outrageous surprise medical bills. Texas has some of the highest rates of surprise billing in the nation and is home to the nation’s largest population of FSERS—one of the worst sources for costly surprise medical bills.

“Any medical care for Texas patients should be a lifeline— not a financial set-up. Yet many freestanding emergency rooms in Texas have demonstrated a clear pattern of withholding important information from—and, in some cases, outright lying to—patients regarding their network status and the prices they will charge for their services,” said Texas Association of Health Plans CEO and registered nurse Jamie Dudensing. “Texas lawmakers have heard enough horror stories from their constituents about outrageous surprise bills from freestanding ERs that have landed them in serious medical debt, and today the Texas House took action. Rep. Oliverson’s bill will ensure freestanding ERs stop using misleading advertising, confusing language and other deceptive practices to rope Texas patients into paying exorbitant prices for routine care.”

FSERs—facilities that charge emergency care prices but usually look like urgent care centers and tend to attract patients seeking treatment for minor conditions—lead to more than $3 billion a year in avoidable health care costs and are responsible for 83% of all out-of-network emergency room services in the state. The legislation is clearly necessary in light of a recent AARP investigation that found many Texas FSERs mislead patients.

According to the study, 77% of FSERs use confusing language such as stating they “take” or “accept” insurance when they are out of network for any major health plan, nearly 30% claimed they were in Blue Cross and Blue Shield of Texas’ network when they were not, and 30% of FSER websites do not comply with state network transparency laws.

HB 2041 by Rep. Tom Oliverson, R-Cypress, would address Texas’ FSER transparency problem by:

  • Stopping FSERs from posting a health plan’s logo unless they are in that health plan’s network.
  • Preventing FSERs from using language that implies they “take” or “accept” a patient’s insurance unless they are an in-network provider with that plan.
  • Requiring FSERs to notify patients about any applicable facility and observation fees before providing a service.

HB 2041 would also require FSERs to post a notice declaring the facility may be out of network with a patient’s health plan, report patient discharge data and more prominently display disclosures required by law on their website. Violations of the new law would become aligned with those for hospital ERs and would be subject to the deceptive trade practices act.

To view AARP’s investigation, click here.
To view TAHP’s findings from its out-of-network claims survey, click here.
To view an example of an outrageous FSER bill, click here.
To view HB 2041 by Rep. Oliverson, click here.

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The Texas Association of Health Plans

The Texas Association of Health Plans (TAHP) is the statewide trade association representing private health insurers, health maintenance organizations, and other related health care entities operating in Texas. Our members provide health and supplemental benefits to Texans through employer-sponsored coverage, the individual insurance market, and public programs such as Medicare and Medicaid. TAHP advocates for public and private health care solutions that improve the affordability, access and accountability of health care for many Texans. As the voice for health plans in Texas, TAHP strives to increase public awareness about our members’ services, health care delivery benefits and contributions to communities across Texas.


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