Texas House Bill Pushes ER Insurance Network Transparency

Published June 4, 2019

The bill attempts to address consumer complaints that providers fail to answer questions about network status and prices because they are prohibited from doing so under the federal Emergency Medical Treatment and Active Labor Act (EMTALA). Congress passed the act in 1986 to require emergency services to treat patients regardless of their ability to pay. One complaint is facilities may tell consumers they accept insurance but not disclose the networks in which patients are covered.

In 2009, Texas passed legislation allowing the formation of independent, licensed, freestanding ERs. These facilities differ from urgent care in offering much more comprehensive service, such as trauma care, and they are staffed around the clock by ER physicians. The option was created as a partial solution to the lack of hospital ERs in remote areas.

H.B. 2041 would require these freestanding ER’s to place signs regarding insurance networks throughout the facility and offer each patient written documentation of facility and observation fees and notice that treatment may not be covered as an in-network provider. State Rep. Tom Oliverson (R-Cypress), who sponsored the bill, is a physician.

Devon Herrick, a health care economist and policy advisor to The Heartland Institute, which publishes Health Care News,says it remains unclear how these facilities would respond to such a law.

“The ERs say it violates federal law,” said Herrick. “On the other hand, I don’t know why Texas cannot regulate medical providers within its borders. A few years ago, the Texas Department of Insurance did not agree EMTALA prevented ERs from answering questions about price, if asked.”

H.B, 2041 was placed on the general state calendar April 29. The 2019 legislative session ends May 27.

AnneMarie Schieber([email protected]is managing editor of Health Care News.

 

Official Connections:

Texas State Rep. Tom Oliverson (R-Cypress)

https://house.texas.gov/members/member-page/?district=130