HB 1635 Oppose One-Pager – Blocking Fraud Detection Undermines Prudent Layperson Protections

TAHP opposes House Bill 1635, which would weaken the prudent layperson standard by prohibiting health plans from using diagnosis patterns to detect emergency room fraud. This change does not align with federal law and would prevent insurers from investigating upcoding and other abusive billing practices—particularly rampant in Texas freestanding ERs. Texans are already protected from coverage denials based on final diagnoses alone; HB 1635 removes the last safeguard against abuse, driving up costs for everyone.

Click here to view TAHP’s one-pager in opposition to HB 1635.

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