Require Network Directory Accuracy

TMA Testimony by Rick Snyder, MD

Senate Business and Commerce Committee
Senate Bill 1742 by Sen. Jose Menendez

April 9, 2019

Chairman Hancock and committee members, my name is Dr. Rick Snyder, and I am a cardiologist from Dallas. I also serve on the Texas Medical Association Board of Trustees, and today I am testifying on behalf of TMA in support of Senate Bill 1742.

The basic product of a health insurance company is a comprehensive facility and physician network for the covered members. Balance billing events most commonly occur when a patient is receiving care at an in-network facility by an out-of network physician. The problem for both patients and physicians is not being able to easily match up the in-network facilities with in-network specialists. While I can find for a given city what physicians are in network, and what facilities are in network, there is no easy or uniform way to cross-reference the in-network facilities with in-network, facility-based physicians who provide services there.   

Requiring insurance companies to report online their physician directories at each facility grouped by specialty empowers both patients and physicians in the struggle against balance billing events through four key benefits: 

  1. Companies and individuals, when shopping for an insurance product during the enrollment period, will be able to confirm more easily that they will have access to a comprehensive specialty network practicing at their favorite in-network facility. 
  2. This in turn brings market pressure to bear as insurance companies, not willing to have gaps in their facility-based specialty networks so easily identified, will want to shore up their physician networks, come to the bargaining table, and negotiate for network adequacy.
  3. Patients who need care and their family members will be empowered by being able to go online and directly confirm for themselves that each member of their physician team is in network. This will have the added benefit of giving them peace of mind that they are less likely to be exposed to a potential balance billing event when they should be focused on getting healthy.
  4. Physicians who need to bring in other specialists to help co-manage a patient also will be able to easily identify in-network physicians. 

Through network transparency, the battle against network inadequacy and surprise billing can be won. 

I am grateful to Senator Menendez for filing this legislation because it provides a commonsense solution to the problem of surprise billing. It would require health insurance companies’ online directories to serve as a guide to which facility-based-physicians provide services at the in-network facilities. 

This will help me protect my patients from a surprise out-of-network billing situation and help with better coordination of care. As a physician, I try to ensure my patients’ experience with medicine is the best possible for themselves and their families. This legislation would be a helpful tool towards that end.

Thank you, Mr. Chairman, for allowing me to share my thoughts today.

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Last Updated On

April 09, 2019