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TAHP News: TAHP News

Texas Insurer, Business and Consumer Groups Agree on Ending Surprise Medical Billing for TX Patients

Monday, February 11, 2019  
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February 11, 2019

John Ford,



Texas Insurer, Business and Consumer Groups Agree on Ending Surprise Medical Billing for Texas Patients

Joint statement calls for a solution to lower the cost of care, fairly compensate providers and protect patients from surprise billing

AUSTINA group of eight Texas health insurance, business, and consumer groups released a consensus statement today calling for an end to the practice of sending surprise medical bills to patients.

The statement, which was signed by the Texas Association of Health Plans (TAHP), AARP Texas, the Texas Association of Business (TAB) and others, highlights the prevalence of surprise medical billing for out-of-network emergency care in Texas, as well as consumers’ inability to ensure they receive in-network care for an emergency. The organizations plan to work with the Texas Legislature this session to pass legislation ending the practice of surprise billing.

Texas is leading the nation with some of the highest rates of out-of-network emergency care providers and surprise medical billing. Three hundred of Texas’ 407 hospitals have no in-network ER doctors available for the major three health plans, and almost 50 percent of all Texas ER doctor claims are out-of-network, which is substantially higher than for all other types of health care providers. As a result, one in three emergency room (ER) admissions in Texas results in a surprise bill—nearly twice the national average of one in five. Freestanding ERs also contribute to the problem, submitting 83 percent of all out-of-network ER facility claims in Texas.

Even though Texas leaders have taken steps over the past decade to create protections from surprise medical bills, problems remain in Texas—particularly in the ER.

“We still see it over and over again in the news—Texans constantly receive outrageously-high surprise medical bills for health care they receive in an emergency,” said TAHP CEO Jamie Dudensing. “We are committed to working with the legislature this session to put an end to surprise billing and make sure patients are no longer held hostage during these billing disputes.”

The consensus statement released today lists the following principles to ensure Texas patients receive high-quality, affordable care:

  • Everyone in Texas deserves affordable, high-quality coverage and care, and control over their health care choices.
  • Patients should be protected from surprise medical bills.
  • Health care providers should be fairly compensated.
  • State policy should restrain costs and ensure quality networks.
  • Patients should be informed when care is out-of-network.

In addition to TAHP, AARP Texas and the Texas Association of Business (TAB), the letter’s other signers include the Center for Public Policy Priorities (CPPP), the National Multiple Sclerosis Society, the Texas Association of Life & Health Insurers (TALHI), Texas Association of Health Underwriters (TAHU) and the National Federation of Independent Business (NFIB).

To view the consensus statement, click here.

To view TAHP’s one-pager on surprise billing in Texas, click here.

To view TAHP’s update on the Texas insurance market and surprise billing, click here.

About TAHP

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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