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Bill to Protect Texas Patients From Price-Gouging at Freestanding ERs Heads to Senate

Wednesday, May 8, 2019  
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May 8, 2019

John Ford, jford@tahp.org

 

 

Bill to Protect Texas Patients From Price-Gouging at Freestanding ERs Heads to Senate

Freestanding ERs are responsible for more than $3 billion in unnecessary health care costs each year in Texas

AUSTIN—New legislation that would allow the Texas Attorney General to hold Texas freestanding emergency rooms (FSERs) accountable for price-gouging patients passed the Texas House today unanimously by a vote of 147 - 0. The bill is modeled after similar laws that work to prevent entities from price-gouging for necessities during natural emergencies.

“Texans experiencing personal medical emergencies shouldn’t have to worry about receiving outrageously-high medical bills for care they may need to save their lives. Unfortunately, many freestanding emergency rooms are set up to price-gouge patients, so Texans do have to worry about that,” said Texas Association of Health Plans CEO and registered nurse Jamie Dudensing. “Patients are finally speaking up and Texas lawmakers are listening. Rep. Phelan’s bill is vital to ensuring these facilities stop taking advantage of Texas patients when they’re at their most vulnerable.”

Because FSERs are rarely in network with patients’ health plans, they can charge outrageously-high prices for services and surprise bill patients for whatever amount remains after the health plan’s payment. For example, one FSER charged a patient over $70,000 in facility and physician charges for eight stitches and two follow-up visits in 2018.

The bill would base the protection on the current statutory provision addressing the sale of necessities such as fuel, food and medicine at excessive prices during a natural disaster. If passed, the Texas Attorney General would be given the authority to take action to protect consumers who are victims of price-gouging in a medical emergency.

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.

HB 1941 by Rep. Dade Phelan, R-Beaumont, would:

  • Protect patients from financially-devastating FSER charges when they seek help in a personal emergency.
  • Stop FSERs from charging “unconscionable” prices for care that is at least 200% higher than the average hospital charge for a similar service.
  • Allow the state to take action against FSERs that engage in “unconscionable” pricing.

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 1941 by Rep. Phelan, 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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