NU Online News Service, April 30, 5:28 p.m. – The Texas Department of Insurance is boasting that its year-long effort to enforce the state's prompt-payment law has generated $15 million in fines and $36 million in restitution for doctors and other health care providers.
So far, 47 health maintenance organizations and insurance companies have agreed to prompt-payment consent orders, officials say.
But Leah Rummel, executive director of the Texas Association of Health Plans, Austin, says the Texas department's actions will do more harm than good.
Texas has "the toughest standards in the U.S. and the toughest penalties," Rummel says. "It does have a very punitive result, and it's not helping the rise of health care in Texas."
The current bill charges are unreasonable, and plans are going to have to pass those costs on to the consumer, Rummel says.
Rummel says HMOs really try to pay claims on time.
"I think it's good to have compliance, but there are going to be human errors," she says.
The latest consent orders, signed recently by Texas Insurance Department Commissioner Jose Montemayor, require 12 insurance companies to pay $1.7 million in fines and an unknown amount of restitution. The companies already have paid $2.6 million in restitution in anticipation of the orders and are expected to pay still more, officials say.
The Texas department says Methodist Care Inc., Houston, has led the 12 companies with $2 million in provider restitution payments.
