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Life Health > Health Insurance

Texas Health Carriers May Have To Disclose Fees

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NU Online News Service, June 5, 10:33 a.m. – The Texas Department of Insurance has proposed rules that would require health maintenance organizations and health insurers to disclose their fee schedules and coding procedures to health care providers.

Gov. Rick Perry, a Republican, asked the Texas department to propose the new rules earlier this year, after the attorney general’s office upheld the insurance commissioner’s authority to require fee disclosure contract provisions.

Perry asked for the new rules because he believes lack of access to fee information keeps physicians from determining whether health carriers have lived up to the terms of their contracts, according to the Texas department.

The proposed rules would require health carriers to give physicians descriptions of fee schedules, coding policies and other policies that might affect payment amounts.

The carriers would have to give physicians at least 60 days’ notice before making material changes to the payment policies, the Texas department says.

Drafts of the proposed rules are posted on the Texas department Web site, at http://www.tdi.state.tx.us/commish/bundling.html and http://www.tdi.state.tx.us/commish/preferred.html


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