Medical claims bill veto angers THA, and TMA

June 20, 2001

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Medical claims bill veto angers doctors groups

By Amy Schatz

American-Statesman Staff

Tuesday, June 19, 2001

Two weeks ago, the Texas Hospital Association endorsed Gov. Rick

for governor in 2002. But on Sunday, vetoed one of the association's

top priorities for the legislative session — a bill that would have required

insurers to promptly pay routine medical claims.

Doctors and medical groups across the state criticized the veto

Monday.

" Hospitals are disappointed that the governor chose to veto House

Bill 1862, " said association president Bettis in a statement. " Many

health plans continue to find loopholes to avoid paying hospitals for medically

necessary services covered by a patient's health insurance. "

The reaction was echoed by the Texas Medical Association.

" Governor 's veto of HB 1862 gives the profit-driven

managed-care industry in our state a license to steal, " said a statement from

TMA president Dr. Tom Hancher. " This untenable situation cannot be remedied by

dumping the problem back in the lap of the commissioner of insurance. "

The bill would have set stricter requirements on how quickly claims

must be paid and imposed fines on insurers who don't pay on time.

said the legislation would have hurt the ability of health

insurance plans to settle disputes through alternative methods or binding

arbitration. The bill would likely " send more disputes to the courthouse for

resolution, further delaying the payment of claims, driving up the cost of

health insurance premiums, and increasing the number of uninsured Texans, "

said in a statement.

The bill's sponsor said he was surprised by the veto.

" I was kind of shocked and disappointed that the governor doesn't

feel that HMOs should pay their bills on time, " said Rep. Craig Eiland,

D-Galveston. " If the governor had come to me even before the floor debate, or

during conference committee, and said he wanted to change the arbitration

provision, we would have changed it. The rest of the bill was too important. "

A spokesperson for the hospital association said the group doesn't

plan to change its endorsement. But the veto could make it harder for to

win further political support from health-care providers.

" It may be hard to understand how important this bill was to every

doctor in the state, and it'll be a tough sell to tell doctors to support him, "

said Dr. Sloane, a Fort Worth physician who has helped lobby for the

medical association. " This is a tragedy. I just don't know of any bill that went

to the heart of the problem that every doctor in the state faces every single

day. "

Health insurers and the Texas Association of Business and Chambers

of Commerce lobbied fiercely against the bill, which they argued would help

trial lawyers more than doctors.

" It would have driven up the cost of health insurance and increased

the number of uninsured Texans, " said Bill Hammond, the business association's

president.

On Monday, directed the Department of Insurance to be more

aggressive in enforcing existing prompt pay laws. Recently, the department

appointed an ombudsman to look into the thousands of complaints of delayed

payments the state receives each year.

But many doctors and hospitals worry that little will improve.

At the town Medical Center Clinic, administrator Guzzino

estimates the office has about $500,000 worth of overdue unpaid claims.

" This legislation was heaven's answer to our prayers that we might

get paid in a business-like, timely way, " Guzzino said. " This is horrific. "

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You may contact Amy Schatz at aschatz@... or (512)

912-5932.

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