Blog Post

Rhonda Sandel

Board President, Texas Association of Freestanding Emergency Centers (TAFEC)

Now is the time for Texas legislators to act on behalf of Texas patients and their families

By Rhonda Sandel, Board President, Texas Association of Freestanding Emergency Centers (TAFEC)

Texans, with the legislative session in Austin quickly winding down, we need a remedy for insurance claim denials—fortunately, we have one in the form of HB 1832.

It allows the Texas Legislature to support patient rights; defend consumer protections; and prevent insurance companies operating in Texas from intimidating patients and influencing their care decisions.

Authored by Reps. Julie Johnson, Tom Oliverson, and Stan Lambert, it has fifteen co-authors (which gives you a sense of how important this legislation is to their constituents and patients across Texas).

This legislation protects patients from the profit-driven manipulations of insurance companies. And it’s worth noting that this legislation is such a priority for pro-consumer elected officials that Senator Donna Campbell is carrying the companion bill, SB 1282 (which is co-authored by her colleague Sen. Dawn Buckingham).

We cannot allow Big Insurance to get between our physicians and us.

HB 1832 would prohibit health plan issuers from implementing any practice that renders coverage for emergency care dependent upon a final diagnosis.

Regardless of whether a symptom, physical complaint, or injury was a true medical emergency, it should be treated as one and covered accordingly.

This bill would end the attack on ER patients and help to restore Prudent Layperson Standard protections. Texans should be able to rely on the fact that existing state and federal laws will be followed and enforced— that if they believe they are having a medical emergency, their care will be covered, according to the law.

It’s no surprise that this legislation is supported by a wide range of pro-patient organizations, including the: Texas College of Emergency Physicians, Patient Choice Coalition of Texas, Texas Medical Association, Texas Orthopaedic Association, the Texas Society of Anesthesiologists, and Texas Association of Freestanding Emergency Centers.

Unanimously voted out of the House Insurance Committee, and strongly supported in the Texas House by a vote of 113-35, the aforementioned organizations and many others are now encouraging legislators on the Senate side to move HB 1832 forward.

And there are other important patient protections worth pushing for this session.

There remains an opportunity to usher in an era of the prompt payment of your medical claims. Thanks to House Speaker Pro Tem Moody, HB 1914 would benefit both patients and providers by ensuring prompt payment of medical claims by insurance companies. If insurance companies violated this requirement, they would be fined. This bill would also improve consumer protections and create greater regulatory certainty.

And importantly, it would help end the balance billing conditions that Big Insurance companies currently thrive on.

The public policies underlying the requirement of emergency care coverage exist to protect patients. Texans need—and are demanding—prompt payment of health insurance claims for emergency care provided by non-network providers.

Medical emergencies prevent consumers from making the kinds of choices they would otherwise make when using a network provider for routine care. To save lives and promote quick access to care, consumers may go to the closest emergency care provider and be assured their potentially life-saving care will be covered.

This bill would aim to bring greater reassurance to patients across the state. One of the biggest reasons for this is because it would prevent your insurance company from taking potentially two to three years to pay your claim. This is an essential fix to a growing problem. That’s why this legislation passed the Texas House with an overwhelming 129-16 majority.

We are now encouraging legislators on the Senate side to move HB 1914 forward.

If you’re reading this, it shows how passionate you are about ensuring that Texans are covered in a medical emergency. Please let your legislator know that you expect them to defend your access to emergency care coverage.

And know this: we are there for fighting for you every step of the way!