Texas House Bill HB3178

Texas 2019 - 86th Regular

Caption

Relating to an interim house study regarding retrospective denial by health benefit plans of health benefit claims for emergency care.

Impact

The study outlined in HB3178 aims to analyze the formal and informal policies enforced by health benefit plans that lead to the denial of claims after emergency services have been rendered. The bill also seeks to evaluate how these practices may hinder residents from seeking timely emergency care, thereby making a critical examination of patient expectations versus the actual benefits offered under their health plans. This analysis is crucial, given the potential consequences of medical debt that often accompany unexpected medical emergencies.

Summary

House Bill 3178 mandates a thorough investigation into the practice of retrospective denial of health benefit claims specifically concerning emergency care. The bill requires the establishment of a standing committee within the House of Representatives to conduct a study and report on how these denials impact residents of Texas. By focusing on retrospective denials, the bill seeks to understand the implications of these practices on patient behavior and out-of-pocket expenses related to emergency medical care.

Contention

A notable concern surrounding HB3178 pertains to the potential conflict with the prudent layperson standard, which is designed to protect patients by ensuring that emergency services are accessible without fear of retrospective denial. Stakeholders in the healthcare field may voice opinions on whether the bill's recommendations for statutory changes could enhance or complicate existing healthcare laws. The outcome of this study could lead to significant modifications within Title 8 of the Insurance Code, thereby impacting both providers and beneficiaries in Texas' healthcare ecosystem.