The Senate Committee on Business and Commerce met on April 18, 2017 to take up a full agenda. The report below covers only discussions on SB 895 relating to information transparency for prescription drugs and SB 2064 relating to freestanding emergency room prices.
SB 895 (Seliger) Relating to the transparency of certain information related to prescription drug coverage provided by certain health benefit plans.
- Clean up bill for HB 1624
- CS simplifies the language on what applies to health plans and to individuals
Jamie Dudensing, Texas Association of Health Plans – For
- This clarifies that bill only works to the individual market.
SB 895 left pending.
SB 2064 (Hancock) Relating to unconscionable prices charged by certain health care facilities for medical care.
- Grants AG Consumer Protection division authority to protect consumers from free-standing ER price gouging
- Excessive prices for free-standing ER care unlawful (150% over average hospital price for similar service)
Carrie De Moor, American College of Emergency Physicians – Against
- Satellites are not held to the same standard, 2/3 of free-standing ERs are hospital-owned
- Could allow hospitals to unilaterally drive up cost of health care
- Studies on hospital cost data have been pulled for questions on the validity of data
- Resource for basing 150% value is not well defined
Blake Hutson, AARP – For
- Hears from clients often on very high prices from frees-standing ERs – not sure if the prices are “unconscionable,” but should definitely be looked into
Jamie Dudensing, TAHP – For
- Database used in this bill is a state database that collects all hospital costs and claims
- Free-standing ERs are not subject tot his same level of oversight
- 150% above “sticker prices” for charges is a huge range and will clearly show bad actors
- Campbell – Why are we not including all ERs?
- Hancock – Data shows where the problems are, tried to keep it narrow & focused
- Campbell – I think this is an attack on ERs
- Hancock – Pretty high threshold that will deal with bad actors
- Campbell – Would like to see the data and investigate this
Maureen Fuhrmann, Texas Association of Freestanding Emergency Centers – Against
- This only targets one access point for emergency care, would like committee to look at all ER service
- TAFEC has done its own study, average lower than hospital-based charges
- Based on TDI complaints, there is a growing trend of underpayment, should look at both sides of the aisle
- Usual & customary charges are defined by the health plans only
- Hughes – Do you have a list of legislative solutions targeting bad actors within your industry?
- We are an advocacy, but we don’t police or enforce
- Hughes – Offering solutions to police bad actors would advocate for your good actors
- Hancock – Interim study pointed out problems in this area, inspired the legislation
- Campbell – Doesn’t the law require insurance companies to process ER bills as in-network?
- Dudensing – 3 mandates around ER services – coverage, ACA rate, and TDI average sticker price
- When TDI passed the mandate, ERs left networks en masse
- Campbell – And the usual & customary is set by insurance companies
- Insurance sets the rate, but the charge is set by TDI
Leslie Weisberg, Blue Cross Blue Shield – For
- Will provide recourse for patients facing very large charges
Emily Bracken, Self – Against
- Has not experienced any unconscionable charges from free-standing ERs
Stan Curtis, Self – Against
- Has not experienced any unconscionable charges from free-standing ERs
- Hancock – The center you went to wouldn’t be impacted by this legislation
SB 2064 left pending