Thu, 21 October 21

It’s Clear: Freestanding ERs Need Transparency, Accountability

by Alicia Pierce, Jamie Dudensing

Freestanding ERs made headlines again as a new report of a COVID test more expensive than a Tesla surfaced and another report of COVID test price gouging came out of Houston.

These stories are just the latest in a string of reports of excessive COVID test prices across Texas and a reflection of persistent price gouging from freestanding ERs. Structurally separate and distinct from a hospital, freestanding ERs are supposed to provide emergency care, but instead mislead and price gouge patients visiting for non-emergency care.

Under their licensing law, freestanding ERs should not be providing non-emergency care. Yet some do not just provide non-emergency care, they actively advertise non-emergency services—such as imaging, telemedicine, and STD testing.

Each session, legislators pass new regulations against freestanding ERs in an effort to stop this abuse, but some freestanding ERs simply ignore these regulations.

That’s why TAHP formally filed a complaint citing dozens of examples of freestanding ERs failing to protect consumers. Our complaint includes evidence of freestanding ER violations of consumer disclosure laws, such as FSER websites including misleading and prohibited statements regarding “accepting” health insurance plans and including prohibited names and logos of health plans for which they are not actually in-network.

One way to hold freestanding ERs accountable is to make them subject to the same price transparency requirements as hospitals. Texas passed significant price transparency requirements during the legislative session, but these laws did not apply to the freestanding ERs or the doctors that work for them.

With a track record of exploitation and failure to comply with regulations, freestanding ERs need more oversight, not less. We should extend the same transparency requirements now required of hospitals.

Right now, when a freestanding ER takes advantage of the system, it is only highlighted when a consumer spots an issue in the paperwork and raises the alarm. Even then, it is hard to know if these are isolated incidents or the long pattern of bad behavior the stream of news stories seems to indicate.

Transparency in health care has bipartisan support and is widely supported by Americans. Price transparency would give payors, policymakers, and enforcement agencies insights to stop price gouging before it starts and to create accountability when it happens. And that’s worth more than a $50,000 COVID test.

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