Our U.S. senators and representatives are back home in Texas for the August recess, and Texas Medical Association President David Fleeger, MD, says their physician-constituents need to contact them to make sure they stop the surprise medical billing epidemic in a way that helps our patients – not big insurance companies.
Thanks to incessant lobbying from physicians, hospitals, organized medicine, and the Physicians Advocacy Institute, a key congressional committee today made significant revisions in a bill to reduce the strain of surprise billing on patients. “This certainly sounds like an improvement,” said Texas Medical Association President David Fleeger, MD, “but the devil will be in the details.”
As Texas prepares to implement an arbitration process to address surprise medical bills, Texas physicians are helping the U.S. Congress work on a federal solution. The House Committee on Energy and Commerce’s Subcommittee on Health tackled surprise billing in a hearing last week to consider the No Surprises Act, draft legislation put together by two committee members.
Some Texans receive medical bills they did not anticipate, even though they have health insurance. Their insurance might not cover that care or provide as much benefit as they assumed. And too often health insurers’ plans have narrow networks (when they do not include enough physicians in their networks), or unexpected limits on what they pay for out-of-network care. When those things happen the insurer pays less of the bill, meaning you, the policyholder and patient, pay more.
Physicians don’t like surprise medical bills either, and we empathize with our patients. We recognize this is a problem, which is why TMA convened a Special Task Force on Balance Billing that studied the causes and prescribed a plan to stop surprise bills. That prescription looks in all directions for solutions to this problem.
Background: The Problem and Its Causes
Doctors understand it’s frustrating to have health insurance coverage but still receive unexpected medical bills. Watch this video to learn about Stanley and the surprise medical bills he received… and learn why he received them.
TMA has developed a one-page patient handout describing the most common reasons for "surprise" medical bills, and a longer document with more details.
The surprise bill problem has many causes, so the TMA Task Force on Balance Billing studied the causes and prescribed a plan to stop surprise bills.
Download TMA's Surprise Bill Prescription
Health insurance companies' use of narrow networks and unexpected limits on how they pay for services out of network are leaving Texans with medical bills they didn't expect. This comprehensive TMA white paper explores "How Health Insurance Company Practices Leave You Without the Coverage You Thought You Bought." Written for journalists, lay-people and policymakers, this easy-to-follow guide connects the dots between insurance company business practices and patients' surprise bills.