Today it was announced that since the No Surprises Act went into effect at the beginning of the year, Americans haveavoided more than 2 million surprise bills. The law protects patients from most surprise medical bills and removes them from the middle of negotiations between providers and insurers when it comes to disputes on what should be paid. That’s the good news.
The use of emergency rooms for primary care services is decreasing, thanks to Medicaid managed care. A recent report by the Texas Health and Human Services Commission (HHSC) shows a 15.5% decrease in the number of potentially preventable emergency room visits in Texas Medicaid and CHIP programs. This is great news for both Medicaid members and taxpayers. Utilizing preventative and standard care before conditions become emergencies leads to better health outcomes and to less costly care.
Can driving just a few miles save a patient thousands of dollars? If they’re in the market for health care, the answer is yes. In Dallas, according to a recent article in D Magazine, the cost of a gallbladder removal surgery can range from $5,000 to $35,000. And rarely are prices posted online—even though they’re supposed to be.
Download PDFBy Jessica Lynch As the public health emergency winds down, millions risk losing Medicaid coverage, not because they no longer qualify but because they get caught in the redetermination process once continuous coverage ends. However, one population faces continual risk for interrupted coverage — pregnant Texas women. When a member loses their Medicaid benefits…
Download PDFby Jamie Dudensing and Alicia Pierce A recently announced change to the administration of the Affordable Care Act will expand access to affordable health insurance for an estimated 5 million Americans. In Texas, it could provide options for more than 600,000 of the state’s uninsured. Currently, individuals qualify for subsidies even if they have…
his week HHS released a proposed rule that takes steps aimed at stabilizing the individual and small group health insurance markets. The proposed rule “would make changes to special enrollment periods, the annual open enrollment period, guaranteed availability, network adequacy rules, essential community providers, and actuarial value requirements; and announces upcoming changes to the qualified health plan certification timeline.” Read more from AHIP here.
.HAC started meeting this week with presentations by the Legislative Budget Board. On Wednesday the LBB provided an overview of Medicaid. Total Medicaid funding in the 2016-17 adjusted base is $26.3 billion GR and $64.6 billion in AF. This includes an estimated $1.2 billion in GR funds above the 2016-17 Budget to complete fiscal year 2017 expenditures, which includes revenue adjustments, transfers, and assumed supplemental funding. House Bill 1, as introduced includes $27.0 billion in GR funds and $65.5 billion AF for Medicaid in 2018-19, which is an increase of $0.7 billion in General Revenue-Related Funds and $1.0 billion AFs. The committee had many questions about Medicaid managed care, capitation rate setting and savings, and STAR Kids. TAHP staff immediately started meeting with offices to educate them on the value of managed care and will continue meetings over the next several weeks. LBB Recommendations for HB 1 can be found here.
This week, TAHP, TAB, TALHI, TAHU, and TORCH launched a coalition to raise awareness about freestanding ERs, their exorbitant pricing and misleading advertising that are confusing consumers and contributing to a serious emergency care cost crisis in Texas. Texans For Affordable Healthcare (TAHC), a healthcare advocacy coalition, seeks to educate the Legislature and Texas consumers about the non-transparent, anti-consumer tactics frequently used by freestanding emergency rooms, as Texas is home to more than half the nation’s FSERs. TAHC will be reaching out to Texans who have experienced surprise bills and confusions at FSERs and are willing to share their stories with others and the Legislature. Our coalition is seeking the following solutions to better protect consumers: