2017 TAHP Managed Care Conference & Trade Show

October 23-25, 2017 • Registration Coming Soon!

The 2017 TAHP Managed Care Conference, “Connect. Innovate. Achieve.,” is quickly approaching! The conference will feature Dr. Uwe Reinhardt, one of the nation’s leading authorities on health care economics, plus a high-level roster of dynamic speakers who will be coming together to brainstorm and discuss ways to achieve greater value, affordability, transparency, and accessibility in health care.

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Medical Directors Forum

Make plans now to attend or sponsor our next Medical Directors Forum. Please RSVP to Patti Doner at pdoner@tahp.org form more information.

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TAHP Membership

Led by a team of seasoned health care policy and advocacy experts, the Texas Association of Health Plans is the statewide trade association representing health insurers, Medicaid plans, Medicaid Advantage plans, and other related entities in Texas. Experience the benefits of TAHP membership by joining today! Build relationships, promote your services, stay informed, and ensure you are well represented in the halls of the Texas Capitol and throughout the State government.

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Building and Fostering Meaningful Relationships

TAHP hosts events year-round that provide opportunities to network in fun, informal venues with other health insurance and health care executives and professionals, legislators, agency leaders, and Capitols staffers and build meaningful relationships.

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Making a Positive Impact on the People of Texas

In addition to playing an integral role in keeping Texas healthy by covering more than 17 million Texans, the Texas insurance industry yields positive results for the economy—creating jobs and opportunity, and generating significant economic revenue for our State.

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Advocating for a Healthy Texas

The TAHP team is comprised of seasoned policy, government relations, and communications professionals with decades of experience on the state and federal levels. These key staff members successfully strategize, build relationships, and advocate for solutions that will make health care more affordable, more accessible and more valuable for all Texans.

More About TAHP Advocacy & Issues

Latest TAHP News
TAHP, TAB & Others Launch Coalition to Tell the Truth About Freestanding ERs

This week, TAHP, TAB, TALHI, TAHU, and TORCH launched a coalition to raise awareness about freestanding ERs, their exorbitant pricing and misleading a. . . read more Thu, 23 Feb 2017 19:15:07 GMT

HAC Begins Meeting

HAC started meeting this week with presentations by the Legislative Budget Board. On Wednesday the LBB provided an overview of Medicaid. Total Medicai. . . read more Thu, 23 Feb 2017 19:15:06 GMT

Trump Administration Releases Proposed Rule Addressing Market Stabilization Issues

This week HHS released a proposed rule that takes steps aimed at stabilizing the individual and small group health insurance markets. The proposed rul. . . read more Thu, 23 Feb 2017 19:15:05 GMT

Texas Association of Freestanding Emergency Centers Makes False Claims About Underpayments By Insura

The Texas Association of Freestanding Emergency Centers (TAFEC) issued a press release this week claiming 3,400 requests for mediations in Texas are c. . . read more Thu, 23 Feb 2017 19:11:57 GMT

Legislators File Bill Extending Sunset Date of State-Run Medicaid Formulary

HB 1917 (attached) was filed this week by Raymond, Zerwas, and Four Price.  The bill extends the sunset date of the state run VDP Medicaid formul. . . read more Thu, 23 Feb 2017 19:10:20 GMT

HHSC Releases 2017 Fact Book

HHSC has released the Fact Book for 2017, which provides overview of Medicaid programs and caseloads and the 11th Edition of Medicaid/CHIP in Perspect. . . read more Thu, 23 Feb 2017 19:09:03 GMT

CMS Projects Accelerating Health Care Cost Growth

Overall health care spending is expected to rise over the next decade and account for 19.9% of the economy by 2025, with the pace of growth to rise 5.. . . read more Thu, 23 Feb 2017 19:08:38 GMT

Kaiser Releases Interactive Tool to Compare Proposals to Replace ACA

A new interactive tool from the Kaiser Family Foundation enables users to create side-by-side comparisons of major ACA alternative plans, now includin. . . read more Thu, 23 Feb 2017 19:06:02 GMT

AHIP: 20 Million Americans Have Health Savings Accounts

The use of health savings accounts has exploded over the last decade, according to a new survey released by AHIP. Just over 20 million Americans had a. . . read more Thu, 23 Feb 2017 19:05:13 GMT

Reminder/Materials for Visiting Capitol Offices

Just a reminder that TAHP has everything you need to visit Capitol offices and get the word out about legislative priorities, including Session Guides. . . read more Thu, 23 Feb 2017 19:03:38 GMT

House Committee Scheduled Announced

Click here to access the full 85th House Committee Schedule. Below are important hearings happening next week: Monday The House Appropriations Subcom. . . read more Thu, 23 Feb 2017 19:02:25 GMT

FOR IMMEDIATE RELEASE • May 24, 2017

FOR MORE INFO CONTACT: Jessica Sandlin, jsandlin@tahp.org


Governor Abbott Signs Legislation to Better Protect Consumers Against Surprise Medical Bills

AUSTIN—The Texas Association of Health Plans (TAHP), the statewide trade association representing commercial and public health plans operating in Texas, today applauded Governor Greg Abbott’s signing of Senate Bill 507, legislation expanding protections for Texas consumers against the growing practice of surprise medical billing or “balance billing”, authored by Texas Senator Kelly Hancock and Representative John Frullo, into law. Surprise or balance billing occurs when insured patients receive out-of-network care, often in an emergency care situation, and are billed by a provider for fees that exceed the amount paid by the insurance—charges that can be 10-20 times the going rate. Texas is home to some of the highest surprise billing rates and emergency care costs in the nation.

SB 507 would expand mediation protections, already being successfully used on a limited basis by consumers in Texas, for insured consumers with PPO plans to all out-of-network emergency providers, including all freestanding emergency rooms, and all of out-of-network providers working at a network facility. Mediation is a process by which consumers can challenge surprise medical bills and leave the dispute to the insurer and provider. This legislation builds on a law written by Sen. Hancock in the 84th Legislature that made mediation available to consumers who were balanced billed by six types of facility-based providers: radiologists, anesthesiologists, pathologists, ER physicians, neonatologists and assistant surgeons.

“With some of the most expensive ER costs and highest rates of out-of-network ER docs in the country, Texas is ground zero for exorbitant, surprise, out-of-network emergency medical bills, and Texas patients are paying the price,” said Jamie Dudensing, TAHP CEO and a former practicing nurse. “Consumers have long-deserved the ability to challenge these expensive medical bills, and this legislation will go a long way to empower them with the tools they need to do just that. TAHP applauds Chairmen Hancock and Frullo for introducing this legislation and Governor Abbott for championing Texas consumers by signing this bill into law.”

 

Texas is home to:

  • Some of the highest rates of out-of-network ER physicians: 50% of ER physician claims are out-of-network
  • Some of the highest rates of surprise billing in the U.S.: McAllen, TX has seen 89% surprise billing rates
  • Some of the highest emergency care costs: Texas ER spending by a major health plan is 67% more expensive than the rest of the nation
  • Some of the highest average ER facility charges: Texas’ charges are 36% higher than the rest of the country
  • Highest rates of freestanding ERs, which are chronically out-of-network: Over 200 FSERs in Texas – more than half nation’s total population of freestanding ERs
  • Texans use emergency departments 22% more than the rest of the country

Specifically, SB 507 would:

  • Expand mediation protections to consumers that have a PPO plan to address balance billing through mediation, to all out-of-network emergency providers and to all out-of-network providers working at a network facility.
  • Allow mediation of balance bills from all types of out-of-network providers treating patients at in-network hospitals and other facilities, including free-standing emergency departments. (Current law applies only to the six listed types of facility-based physicians: radiologists, anesthesiologists, pathologists, ER physicians, neonatologists and assistant surgeons).
  • Allow mediation of balance bills for emergency care from any provider or facility of emergency care services, including freestanding emergency departments.
  • Expand disclosure requirements regarding network status and balance billing by insurers, facilities and other health care providers, including the requirement that the following statement be included on balance bills: “This is a balance bill that may be eligible for mediation.”
  • Expand mediation protections to the Teachers Retirement System (Already applies to the Employee Retirement System).

Additional resources on emergency medical costs in Texas can be found below:

Amerigroup Texas Names Health Plan President

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BCBS TX Names New President

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