Wars Over New Texas Out-of-Network Laws: PCCOT Is a Voice for Patients

On March 02, 2016, Texas Dept. of Insurance (TDI) will hold its first out-of-network "Town Hall meeting" on escalating wars over new Texas out-of-network law (HB574) since it went effect on Sept. 01, 2015. PCCOT is a voice for all patients in Texas.

On Feb 22, 2016, Patient Choice Coalition of Texas (PCCOT) announced that it will participate in the first TDI out-of-network Town Hall meeting on March 2, 2016, on the escalating wars over new Texas out-of-network law (HB574) since it went into effect on Sept. 1, 2015. PCCOT urges all concerned patients to share with PCCOT, before March 2, 2016, any violations of patient rights to freedom of choice for in-network or out-of-network providers.   PCCOT Is a voice and advocate for all patients in Texas helping to preserve the patients right to choose, and protect them against any surprising or unexpected out-of-network medical bills.

According to TDI’s website, on March 2, 2016, TDI will host an “informal stakeholder meeting” at William P. Hobby Jr., State Office Building 333 Guadalupe, Tower 3, Room 102, Austin, TX. “The Department invites interested stakeholders to attend an informal stakeholder meeting to discuss issues that have arisen regarding out-of-network referral disclosure forms and compliance with recently enacted legislation.”  http://www.tdi.texas.gov/alert/event/2016/03/stkhldr302.html

"We have heard many heart-breaking and disturbing stories and complaints from our members since HB574 (commonly referred to as the Texas Out-of-Network Patient's Bill of Rights) went into effect on September 1, 2015", says Mr. Dan Chepkauskas, Executive Director of the PCCOT, a long-standing patient advocate and legislative activist.

Dan Chepkauskas,, Executive Director of the PCCOT

Since Sept 1, 2015, PCCOT has received numerous complaints from its members and has filed many of them with TDI against many carriers. PCCOT will attend this “informal stakeholder meeting” to be a voice for immediate investigation and vigorous enforcement of  HB574 for any violations of the patient’s rights to choose and against any impermissible surprising out-of-network medical bills.

“We have heard many heart-breaking and disturbing stories and complaints from our members since HB574 (commonly referred to as the Texas Out-of-Network Patient's Bill of Rights) went into effect on September 1, 2015”, says Mr. Dan Chepkauskas, Executive Director of the PCCOT, a long-standing patient advocate and legislative activist.

According to the TDI notice on its website: “Some carriers in Texas require the use of out-of-network referral disclosure forms which required the signature of both the provider and the patient attesting to the fact that certain information was provided to the patient.  Concerns have arisen as to whether the forms might inhibit patients from obtaining out-of-network services that they may be entitled to under their insurance policy.  For instance, at least one of the disclosure forms:

1.  Requires that an in-network provider option be provided to the patient on the out-of-network referral form when there is not a clinical reason for the referral to the out-of-network provider,

2.  Advises that the consumer will have higher out-of-pocket costs if they use out-of-network providers,

3.  Advises that the carrier may not pay the claim if the out-of-network provider waives the patient payment responsibility, and

4.  Advises that fee-forgiving could be considered fraud.”

http://www.tdi.texas.gov/alert/event/2016/03/stkhldr302.html

“PCCOT strongly supports TDI in the timely enforcement of HB574, and will do everything possible to protect its' members and all patients in Texas”, says Mr. Chepkauskas.

 According to the TDI website, in addition to the new HB574 provisions in Sec. 1301.0057 ACCESS TO OUT-OF-NETWORK PROVIDERS, and Sec. 1301.0058 PROTECTED COMMUNICATIONS BY PREFERRED PROVIDERS, HB574 also provides Sec. 1301.067(a-1):

“An insurer may not, as a condition of payment with a physician or health care provider or in any other manner, require a physician or health care provider to provide a notification form stating that the physician or health care provider is an out-of-network provider to a current, prospective, or former patient, or a person designated by the patient, if the form contains additional information that is intended, or is otherwise required to be presented in a manner that is intended, to intimidate the patient.”

http://www.tdi.texas.gov/alert/event/2016/03/stkhldr302.html

“PCCOT will assist all patients in filing timely complaints with TDI or Texas Attorney General against any violators of HB574 and any patient’s right laws in Texas.  We invite all concerned parties to share with us your stories or voice your concerns on March 2, 2016 at TDI’s informal stakeholder meeting,” says Mr. Chepkauskas.

About PCCOT:  Located in Austin, TX, PCCOT is a pro-active Legislative lobby group designed to give patients, independent physicians and free-market healthcare issues the same type of attention with the Texas Legislature that insurance companies have enjoyed for years. PCCOT actively engages the most respected healthcare and business lobbyists and attorneys in the State of Texas to advance the issues of its membership.  This not only gives the patient a voice in government decisions being made regarding health care, but a voice which is backed up with ACTION.

To find more about PCCOT, please visit http://pccot.com.

For more information or questions, please contact Mr. Dan Chepkauskas, Executive Director of the PCCOT, at phone number 832-877-0800, or email: pccot@yahoo.com .

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