Testimony Opposing HB 1635 (Prudent Layperson Standard) 4.17.25
TAHP opposes House Bill 1635, which would severely weaken the prudent layperson standard—one of the only tools health plans have to prevent abuse of the emergency room system. The bill would prohibit the use of final diagnosis codes even to flag suspicious claims, and would require costly adverse determinations for every case—shifting power away from oversight and toward providers engaged in abusive billing. By encouraging misuse of ER services and making fraud detection harder, HB 1635 would raise costs for patients, employers, and taxpayers.
Click here to view TAHP’s testimony in response to HB 1635.
