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Texas Hospital Association Accuses Plan Of Payment Delays

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NU Online News Service, June 21, 11:45 p.m. – The Texas Hospital Association, Austin, Texas, has asked Gov. Rick Perry to include prompt pay on the call of a special session for congressional redistricting.

THA, an advocate for the state?fs hospitals and health care systems, and its members requested the governor?fs help to get health plans to pay claims on time.

On June 17, the governor vetoed House Bill 1862, which would have allowed health plans to delay payments to hospitals and doctors, the THA says.

“The prompt pay law was adopted in 1999, and health plans were involved in the Texas Department of Insurance?fs subsequent development of regulations. Yet in 2001, severe problems still exist with retrospective review of medical necessity and denial of payment for previously authorized services,” says Richard Bettis, president of the Texas Hospital Association.

According to THA, the governor indicated in his veto message that his main concern is that H.B. 1862 “would erode the ability of a health plan to agree, through contract or otherwise, to settle contract disputes through alternative dispute resolution or binding arbitration.”

Although the governor directed the state insurance department to aggressively enforce existing law and strengthen the current regulations, “the regulatory process is slow and cannot correct the flaws in the existing law,” Bettis says. “The loopholes must be closed, and penalties ?ewith teeth?f are needed to ensure compliance.”

In his veto message, Perry expressed concerns that lawsuits and insurance premiums would increase, and more Texans would become uninsured, the association says.

“THA shares the governor?fs concerns, and agrees that more lawsuits may proliferate if providers must resort to the courts to obtain contractual payments,” Bettis says. “THA also is concerned that patient choice and access will be limited as hospitals cease participation in managed care networks due to increased administrative costs to secure hospital payment.”


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