Nearly 80 percent of Texas freestanding ERs say they “take” or “accept” insurance but are not in network with any major health plan
AUSTIN—State Rep. Dr. Tom Oliverson, R-Cypress, has filed legislation that would address Texas’ freestanding emergency room transparency problem. Freestanding ERs in Texas are responsible for 83 percent of all out-of-network emergency room services and lead to more than $3 billion a year in avoidable health care costs.
Rep. Oliverson’s House Bill 2041 would enact a new set of requirements on freestanding ERs, including:
Prohibiting the use of health plan logos with which they are out of network,
Prohibiting the use of the words “take” and “accept” in association with a patient’s insurance unless they are an in-network provider with the plan and
Disclosing applicable facility and observation fees to patients upfront.
“Time and again, Texans get confused by misleading advertising and frustrated by exorbitant prices when they seek care from independent freestanding ERs. These facilities have demonstrated a pattern of withholding important information from patients regarding their network status or the prices they will charge for their services,”said TAHP CEO and registered nurse Jamie Dudensing. “Rep. Oliverson’s legislation would ensure Texans have the information they need to better care for themselves and their families without breaking their bank accounts.”
The legislation is clearly necessary in light of a recent AARP investigation that found many Texas freestanding ERs mislead patients. When patients receive emergency care from out-of-network facilities, they run a high risk of receiving expensive surprise medical bills. According to the study, 77 percent of freestanding ERs use confusing language like they “take” or “accept” insurance when they are out of network for any major health plan, nearly 30 percent claimed they were in Blue Cross and Blue Shield of Texas’ network when they were not, and 30 percent of freestanding ER websites do not comply with state network transparency laws.
HB 2041 would require freestanding ERs to post a notice declaring the facility may be out of network with a patient’s health plan, report patient discharge data and more prominently display disclosures required by law on their websites. Violations of the new law would become aligned with those for hospital ERs and would be subject to the deceptive trade practices act.
To view AARP’s investigation into Texas freestanding ERs, click here.
To view HB 2041 by Rep. Oliverson, click here.
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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