NCPA - National Center for Policy Analysis

TRANSPARENCY IN HEALTH CARE COVERAGE

August 1, 2007

Health care coverage is about to become clearer for Texas patients, due to a new law (Senate Bill 1731) the legislature passed calling for transparency of health care costs from health insurers as well as hospitals, physicians and other health care professionals.  The law will allow patients to make better and more informed health care decisions, says the Texas Medical Association (TMA).

Under the bill:

  • The Texas Department of Insurance is required to collect and show consumers health insurer, hospital and physician information including billing, coverage areas, plan costs and premium increases, and the number of health care providers.
  • Physicians, hospitals and insurers will be required to provide patients with billing and collection policies, specific cost estimates and other information related to health care coverage and costs.
  • The law also requires health plans to report where they spend health insurance premium dollars and how adequate their physician network is -- whether the plan has enough in-network specialists nearby to meet patients' varying medical needs.

A host of other new laws intended to help health care consumer were also passed, says TMA:

  • House Bill 1594 prevents patients from paying out-of-network costs when seeing a physician whose new medical group already is under contract by a health plan;
  • House Bill 2015 provides employers with access to health insurance information so they can evaluate employee health care expenditures; and
  • House Bill 522 introduces a pilot project in the Houston area for health insurers to provide patients with their health insurance coverage information using smart-card type technology.

Source: "New Texas Laws Create Transparency in Health Care Coverage," Texas Medical Association, July 23, 2007.

For text:

http://www.texmed.org/Template.aspx?id=5954

 

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