Coalition Outlines Unethical Health Insurance Practices that Place Texas in ‘State of Emergency’
AUSTIN, Texas, May 9, 2017 /PRNewswire/ — Healthcare providers from across Texas gathered today for a press conference at the State Capitol to highlight current negative trends in health insurance and protest harmful business practices by insurers to pay less for emergency care and shift healthcare costs directly to consumers.
The physicians spoke in affiliation with StateEmergency.org, an advocacy coalition dedicated to defending emergency medicine. The coalition organized the press conference to raise awareness about the systematic attacks on emergency care and to request legislative action to protect Texas consumers from detrimental insurance practices.
“Make no mistake, emergency care is under attack by health insurance plans,” said Dr. Andy Wilson, Board Certified in Emergency Medicine and managing partner at CapRock ER in College Station. “Too often, insurers use their purposely constrained network rules to systematically deny, delay, or decrease legitimate claims for emergency services, leaving patients, doctors, and facility owners to pick up the tab for what should be covered. When insurers collect premiums without paying for health services, they make the kinds of record profits like we are seeing today.”
A recent national survey found 95 percent of voters want insurance companies to pay for emergency services, and 90 percent of voters want insurers to be transparent about how they calculate emergency care payments. However, health insurance companies are promoting their own new legislation that will leave patients with even fewer choices when it comes to emergency facilities and physicians and shifting larger portions of healthcare costs to consumers.
Texas currently ranks among the worst in the country when it comes to access to emergency care, receiving a grade of ‘F’ from the American College of Emergency Physicians 2014 Report Card. Despite that fact, health insurance companies are advocating at the State Capitol to keep health networks narrow, which would limit the number of healthcare providers available for Texans for financial gain.
In emergency situations, patients do not have time to research which facilities, physicians, and specialists are in-network for their given health plan. Rather, they seek the immediate care they deserve only to be punished financially by insurers using sly tactics to deny their coverage, to delay processing valid medical claims, or to decrease payments for warranted emergency services. Consumers are now targets for insurers who use the complexity of health insurance to gouge patients financially while not holding up their end of the bargain.
Members of the coalition expressed support for legislative initiatives aimed at increasing health insurance transparency and bolstering oversight to guarantee insurers obey current state and federal statutes. Emergency physician groups have supported bills for greater transparency, including HB 2077, HB 2449, HB 2945, HB 3755, SB 1486, and SB 1614 — critical legislation that will not make it to the floor while insurance company backed legislation advances further, threatening emergency medicine in Texas.
Dr. Gillian Schmitz, Associate Medical Director of Full Spectrum ER and Executive Director for Policy and serves on the American College of Emergency Physicians Board of Directors, explained that legislative interference is needed to preserve access to quality emergency care. “Healthcare policy in Texas is in a state of emergency, and we must act now before the situation worsens. If we don’t, access to quality, affordable emergency care in Texas will suffer along with every Texan who needs it.”
StateEmergency.org is an advocacy coalition composed of patients, physicians, employers, and healthcare providers who have united to stand against health insurance companies and their unethical, systematic practice of underpaying the claims they are legally obligated to cover for emergency medical services. The coalition includes the Texas Association of Freestanding Emergency Centers, The Battle Continues, The Patient Choice Coalition of Texas, Free Market Healthcare, and Speak Up for Your Health.