Health Insurance Group Urges Denial of Freestanding ER Waiver

By Consumers For Quality Care, on September 9, 2020

Health Insurance Group Urges Denial of Freestanding ER Waiver

The Texas Association of Health Plans (TAHP) is calling on the state of Texas to clamp down on freestanding emergency rooms for what they say is price gauging for COVID-19 tests. This comes after freestanding emergency centers in the state sought a waiver to provide non-emergency care during the pandemic, arguing that it would allow them to lower prices.

“It’s important that our state leaders exercise their authority to protect Texas families and employers. No Texan should have to worry about receiving a surprise bill or being price gouged for health care—certainly not during a global pandemic,” TAHP wrote. 

The out-of-network bills often range anywhere from hundreds of dollars to six-figures and result in extra charges to insurance companies. One Texas facility reportedly charged nearly $2,500 for a COVID-19 test that should have cost $175.

In a letter, TAHP argues that the scope of practice for freestanding ERs should not be expanded, but rather investigated. While freestanding ERs have to charge for emergency care, TAHP also argues that there is no basis for how much they need to charge.

“Expanding their licensure would only put more Texas patients at risk of being victimized by FSERs’ predatory behavior. Instead of expanding their scope of practice, Texas should investigate FSERs’ anti-consumer activities,” the letter says.

Lawmakers have recently taken action as well. Texas passed a bill that allows action against charges that are 200% more than what a hospital would charge. Washington, meanwhile, created an emergency order that bans labs from charging insured patients for a COVID test that was ordered by a doctor.