TX Medical Bill Vetoed

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Monday | June 18, 2001

Medical pay bill vetoed Legislation would have set standards 06/18/2001 By J.C. Conklin / The Dallas Morning News

Gov. Rick vetoed legislation Sunday that would have set clear standards on how doctors and hospitals should be paid by health insurers.

Related content• Next execution creating little stir• Governor vetoes ban on executing retarded• Line-item veto gets a workout on last day "It's an absolute tragedy," said Dr. Sloane, a trauma surgeon in Fort Worth. Mr. 's office wouldn't comment on the issue Sunday.

The legislation would have defined a clean claim or bill. Under current law, each individual insurer determines what qualifies as a clean claim. Although the state lists standard elements of a complete claim – such as a patient's birth date and plan identification number – insurers are free to add requirements. An insurer must notify hospitals and doctors 60 days before making changes. Doctors have complained that sorting through each insurer's conditions is arduous.

The legislation would have also required that a claim be considered received by an insurer three days after a doctor mailed it first class and 24 hours after it was sent electronically. Under current law, a claim isn't received until an insurer tells the physician or hospital that it has been.

Rep. Craig Eiland, D-Galveston, said he was shocked. "I am disappointed that the governor has dismissed the idea that folks, even insurance companies, should pay their bills in a timely fashion or give some reason for not doing so," said Rep. Eiland, author of the House Bill 1862.

But insurers cheered the governor's decision. Leah Rummel, executive director of the Texas Association of Health Plans, an advocacy group for insurers, said the bill would have required insurers to specify upfront the number of days in a hospital that they would approve for patients rather than day-by-day as they do now. It also would have required them to have staff answering phones on the weekends and holidays about elective surgical procedures.

"We support prompt pay; however, House Bill 1862 had too many problems," Ms. Rummel said.

Insurers also weren't pleased by a clause that would have limited the use of binding arbitration in contracts. Ms. Rummel said the provision would have made it so physicians were always going to the courts to resolve problems.

Resource: Dallas Morning News 06/18/01

Martha Murdock, DirectorNational Silicone Implant FoundationDallas, Texas Headquarters

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