A law enacted in 2017 by the 85th Texas Legislature, HB 3276 by Oliverson, requires a freestanding emergency medical care facility to list all health insurance plans for which the facility is a participating provider. These facilities, which have become more common across Texas in recent years, are not physically attached to a hospital, although they may have a hospital affiliation.
Under the new law, which took effect September 1, 2017, facilities must post at the facility or online a notice of the health benefit plans for which they are in-network or post at the facility a notice that states that they are not in-network for any health benefit plan. If a facility makes information available only online, it also must give the patient written confirmation of whether it is a participating provider in the patient’s health benefit plan.
The new requirement under HB 3276 builds on a 2015 law, SB 425 by Schwertner, which directed a freestanding emergency medical care facility to post signs and to state online that it charges rates comparable to a hospital emergency room, that the facility may not be in-network for the patient’s health benefit plan, and that a physician at the facility may bill separately from the facility for the medical care provided to a patient.
Supporters of HB 3276 said it would help prevent surprise medical bills for patients who did not have adequate time to check whether the facility was in-network before using it in an emergency. They said that by requiring freestanding emergency medical care facilities to provide clear notice about which health plans are in-network, HB 3276 would help consumers make more informed medical decisions. Some freestanding emergency centers use wording such as “we accept all health plans,” although they are out-of-network for many plans, which can be confusing for patients during an emergency. Supporters said the bill also would reduce the burden on freestanding emergency medical care facilities by allowing them to post health plan network information online, where it can easily be updated.
Critics of HB 3276 said freestanding emergency centers may have contracts with many different health plans under one insurance company name, and even when acting in good faith, centers may have trouble keeping this information current due to the number and variety of plans with which they contract.
Other proposals. In addition to HB 3276, the 85th Legislature considered but did not enact several other bills related to freestanding emergency medical care centers. SB 1592 by Schwertner would have changed the administrative penalties that could be assessed against these facilities. SB 1352 by Watson would have required notice of health care fees to be posted in both English and Spanish. HB 3122 by Farrar would have notified patients whether the facility accepted Medicare, Medicaid or Tricare, and HB 3099 by Paul would have required patients to be notified that a freestanding emergency medical care center was not an urgent care center, which generally charges lower rates.
by Lauren Ames