March 9, 2020
TDI Penalizes BCBSTX for Actions Costing Policyholders
Statement by Texas Medical Association (TMA) President David C. Fleeger, MD, about the Texas Department of Insurance (TDI) sanction of Blue Cross Blue Shield of Texas (BCBSTX) for delaying payment of certain out-of-network emergency care claims. TDI also found the plans distributed incorrect information about how to resolve balance bills to many HMO members who received out-of-network emergency care.
“Kudos to TDI for its consent order imposing a $10 million fine and restitution requirements on BCBSTX related to incorrect notices on explanation of benefits, other discrepancies in marketing material, and delays in processing certain out-of-network emergency care claims.
“The significant administrative penalty sends a strong message to health plans regarding TDI’s consumer protection stance and the importance of health plans providing accurate consumer information.
“This health plan’s errors have financially harmed our patients and countered the efforts of Texas lawmakers trying to rein in patients’ share of health care costs.
“Texas physicians agree with the state. Our patients deserve better.”
TMA is the largest state medical society in the nation, representing more than 53,000 physician and medical student members. It is located in Austin and has 110 component county medical societies around the state. TMA’s key objective since 1853 is to improve the health of all Texans.
Contact: Brent Annear (512) 370-1381; cell: (512) 656-7320
Marcus Cooper (512) 370-1382; cell: (512) 650-5336
Last Updated On
March 09, 2020
Originally Published On
March 09, 2020