{"id":6407,"date":"2017-02-24T20:07:29","date_gmt":"2017-02-24T20:07:29","guid":{"rendered":"https:\/\/losfresnosnews.net\/?p=6407"},"modified":"2017-03-10T20:08:38","modified_gmt":"2017-03-10T20:08:38","slug":"tx-lawmakers-might-revamp-surprise-medical-bill-mediation","status":"publish","type":"post","link":"https:\/\/losfresnosnews.net\/?p=6407","title":{"rendered":"TX Lawmakers Might Revamp \u201cSurprise Medical Bill\u201d Mediation"},"content":{"rendered":"
\"Texas<\/a>

Texas lawmakers are considering improvements to the state\u2019s mediation process for people who get \u201csurprise bills\u201d for out-of-network medical services. Photo: lisafx\/iStockphoto<\/p><\/div>\n

by Mark Richardson<\/strong><\/em><\/p>\n

AUSTIN, Texas<\/strong> \u2013 It can be a major setback for Texas health care consumers: a surprise bill for thousands of dollars from a doctor who isn\u2019t in your insurance company\u2019s network. Texas lawmakers approved a mediation plan in 2015 to allow patients to negotiate those bills, but health care advocates say it\u2019s so complex that too few consumers are using it.<\/p>\n

According to Stacey Pogue, senior policy analyst with the Center for Public Policy Priorities, under the current payment system, a medical procedure can become a Catch-22 for the patient.<\/p>\n

\u201cSay, a colonoscopy \u2013 they often find out if their doctor is in-network and the facility is in-network,\u201d Pogue said. \u201cBut they don\u2019t know to ask \u2013 or they can\u2019t get good information on \u2013 whether the anesthesiologist is going to be in-network; if they have a biopsy and it goes to a lab, if that pathologist in network.\u201d<\/p>\n

Pogue said patients, particularly during emergencies, are rarely informed that they may be treated by an out-of-network provider, and those bills must be paid in addition to any deductibles or co-pays. She said Texas legislators are looking at several ways to address the problem, simplify the process and make it easier to arbitrate the bill.<\/p>\n

Surprise bills have become a hot potato the health care system doesn\u2019t want to deal with, Pogue said.<\/p>\n

\u201cInsurance companies, as you can imagine, and doctors don\u2019t agree on who should pick up the tab. Today, they just push it off on patients because they can,\u201d she said. \u201cAnd so, if the Legislature says \u2018No, you can\u2019t push that cost off on a patient,\u2019 what these other agencies care about is who has to pick up that cost. And that\u2019s the complicating factor.\u201d<\/p>\n

Since 2015, about 250,000 Texans who received out-of-network bills were eligible for mediation, Pogue said, but fewer than 4,000 have taken advantage of it.<\/p>\n

\u201cHopefully, it\u2019ll also help consumers know about the program, because that\u2019s one of the biggest barriers is that they created this program to help consumers, but they don\u2019t know about it,\u201d she said. \u201cIt does require that there\u2019s a notice that\u2019s put on your medical bill that you have a right to mediation.\u201d<\/p>\n

Pogue said she\u2019s confident that the Legislature will act on surprise medical bills this session. She said the issue has bipartisan support in both the House and Senate.<\/p>\n

A report, written by Pogue, on the issue of surprise out-of-network medical bills is available here<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

by Mark Richardson AUSTIN, Texas \u2013 It can be a major setback for Texas health care consumers: a surprise bill for thousands of dollars from a doctor who isn\u2019t in your insurance company\u2019s network. Texas lawmakers approved a mediation plan in 2015 to allow patients to negotiate those bills, but health care advocates say it\u2019s […]<\/p>\n","protected":false},"author":4,"featured_media":6399,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[13],"tags":[],"class_list":["post-6407","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-state"],"_links":{"self":[{"href":"https:\/\/losfresnosnews.net\/index.php?rest_route=\/wp\/v2\/posts\/6407","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/losfresnosnews.net\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/losfresnosnews.net\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/losfresnosnews.net\/index.php?rest_route=\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/losfresnosnews.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=6407"}],"version-history":[{"count":1,"href":"https:\/\/losfresnosnews.net\/index.php?rest_route=\/wp\/v2\/posts\/6407\/revisions"}],"predecessor-version":[{"id":6408,"href":"https:\/\/losfresnosnews.net\/index.php?rest_route=\/wp\/v2\/posts\/6407\/revisions\/6408"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/losfresnosnews.net\/index.php?rest_route=\/wp\/v2\/media\/6399"}],"wp:attachment":[{"href":"https:\/\/losfresnosnews.net\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=6407"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/losfresnosnews.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=6407"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/losfresnosnews.net\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=6407"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}