Testimony Opposing HB 1236: ER Fraud

HB 1236 seeks to modify the “prudent layperson standard” for emergency care health insurance coverage in Texas, ensuring that a health plan cannot deny coverage for ER care based on a final diagnosis. However, the bill’s language extends beyond this intent, creating significant unintended consequences for combating emergency department fraud in Texas. It is crucial to note that both current Texas law and federal law already prohibit a health plan from denying ER coverage based on a final diagnosis.

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