After observing many patients having treatment delayed, denied or thwarted, Texas’ emergency room community took the initiative to work closely with lawmakers to develop laws that would better protect patient rights. Their efforts have resulted in multiple pro-patient bills being proposed to the Texas legislature this year.
About the Proposed Legislation
Doctors have worked closely with Texas lawmakers to bring about much-needed changes in patients’ access to care. House Bill 1832 was proposed by Representative Julie Johnson along with a companion piece, Senate Bill 1282 by Senator Donna Campbell. If passed, these bills would prevent health insurance companies from having any policy or taking any action that conditions payment for emergency services based on a final diagnosis instead of the symptoms that the patient was experiencing to cause him or her to seek emergency medical care. For example, some patients may experience chest pains and may believe that they are having a heart attack, but they may be diagnosed with acid reflux or a panic attack. After receiving multiple tests and care, these patients may then be billed for the entire emergency room visit after the insurance company denies coverage. Doctors express concerns about conditioning payment on a final diagnosis because some patients may be afraid to seek care from emergency rooms if they believe that they may be denied coverage.
Some of the proposed legislation seeks to increase consumer transparency. For example, Senate Bill 1052 would permit emergency care providers to inform patients that their facility is in-network. This bill is being proposed in opposition to the tactic of some insurance companies that prohibits medical providers from informing their patients of their in-network status.
While some of the bills are aimed at providing greater patient protections, some of them also consider the impact on insurance companies. For example, House Bill 1914 written by Representative Joe Moody would require prompt payment of health insurance claims submitted by emergency care providers.
House Bill 1278 would allow emergency clinics to provide outpatient care services to patients. If passed, this could help patients who are advised to wait until the next business day to see their primary care doctor. In particular, doctors are concerned about insurance practices of steering patients away from life-saving care. They have proposed House Bill 4404 and Senate Bill 1054 to prevent these types of practices.
Commitment to Care
The proposed legislation is part of the doctors’ commitment to provide quality care and to remove confusion regarding the decision-making process in emergency care situations. The legislation seeks to impact one or more of the following components of this commitment:
- Assisting Texas patients with having a better understanding of their rights regarding emergency room care
- Protecting patients safe from financial harm
- Decreasing patient confusion
- Defending patients from a lack of consumer protection laws or insurance oversight
- Protecting patients from questionable tactics by insurance companies
Legal Assistance for These Matters
If a patient is harmed because of the actions of an insurance company, the patient may consider seeking legal assistance to address these issues. Insurance companies are required to act in “good faith,” and there are questions when they don’t. Contact our experienced personal injury lawyers for help with your claim.
