Senate Committees Examine How Health Care Providers Are Paid and Public School Finance
The Special Committee on Prompt Payment of Health Care Providers wants to know if health care providers in Texas are being fairly and properly paid by insurance companies, health maintenance organizations (HMOs), and other similar health care payers. Over the past few years, doctors and hospitals alike have criticized the payers for being slow, for making the health care providers wait far too long for their fees. In its meeting today, the committee addressed three separate charges in regard to the controversy.
Charge #1 orders the committee to examine the State Board of Insurance and how its rules and regulations affect the issue. The first witness was Jose Montemayor, Texas Commissioner of Insurance. He gave a brief overview of the differences between conventional insurance and HMOs, as well as how the rest of the financial reimbursement system for health care works. In response to questions from the Senators, he said the Department of Insurance was assessing fines on companies that had refused to pay certain claims. Associate Insurance Commissioners Audrey Selden and Kim Stokes also discussed the enforcement of new federal standards, encouraging the electronic filing of claims, and how prompt pay rules could be better enforced.
Charge #2 regards an overview of the investigation of HMO payment and the Employee Retirement Income Security Act (ERISA) practices by the Attorney General's (AG) office. Edna Ramon Butts and David Mattox of the AG's office testified that certain employer plans cannot be regulated by the states due to federal law. Other questions regarded how the Attorney General enforces rules that must be followed by HMOs and insurance companies, as well as the status of ongoing investigations.
Prompt payment under the Medicaid program is addressed in Charge #3 . Don Gilbert of the Health and Human Services Commission told the committee that of the 800,000 Medicaid recipients in Texas 500,000 are in HMOs and that his agency has the authority they need to ensure that bills are paid on time.
The Senate Committee on Prompt Payment of Health Care Providers is chaired by Senator Jane Nelson of Flower Mound. The Vice-Chairman is Senator John Carona of Dallas. Members include Troy Fraser of Horseshoe Bend, Mario Gallegos of Houston, and Judith Zaffirini of Laredo. Chairman Nelson announced at the end of today's meeting that the committee will be traveling twice after the first of the year and will have at least one more meeting in Austin. The committee recessed subject to call of the chair.
Meanwhile in Amarillo, the Bivins subcommittee of the Joint Select Committee on Public School Finance was holding a public meeting asking Panhandle residents how they think public schools should be financed. Opening remarks were given by Senators Teel Bivins and Eliot Shapleigh. Members present include Senators Bivins of Amarillo and Shapleigh of El Paso, along with Steve Ogden of Bryan and Leticia Van de Putte of San Antonio. Other members present include public members Will Davis, Craig Foster David Thompson and Kent Caperton, along with Representative Kent Grusendorf. The subcommittee's next meeting is scheduled for November 14th in El Paso.