Saturday, August 27, 2016

From the Texas Tribune: In Fight over Surprise Medical Bills, Some Lawmakers Target Insurance Regulators

On more item that might end up on the agenda of the next legislative session.

- Click here for the article.

On April 15, 2015, Ed Hagan spent a sleepless night trying to cope with a sharp pain in his back.
When morning came, Hagan, then a teacher at a Dallas middle school, was too sick to work. He headed to the emergency room at Texas Health Presbyterian Hospital, which he knew was in-network for his health insurance company, Aetna.
Medical tests revealed Hagan had kidney stones. But the news quickly got worse: Doctors suspected Hagan had a rare form of leukemia, and told him he needed to be hospitalized immediately to get tested.|
It was the beginning of more than a year of intensive cancer treatment for Hagan, now 66 and in remission. But the very first day of that ordeal left a lasting — and costly — impression: thousands of dollars in surprise medical bills.
Despite choosing an in-network hospital, the emergency room doctor who treated Hagan wasn't in-network. Neither was the anesthesiologist who worked on Hagan’s bone marrow sampling. Combined, their bills totaled $2,000.|
“Most people don’t know to fight this stuff, or how to write a letter, or how to kick it back at them, saying, ‘You guys got a scam going,’” Hagan said.
State lawmakers have long sought a solution to surprise medical bills — also known as balance bills — as doctors, insurance companies and patients argue over who is responsible for the phenomenon.

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