TMA Physicians and Legislators: 'Patients Have a Right to Know'. - Managed Care Weekly Digest

The Texas Medical Association (TMA) joined with state legislators to launch initiatives today that would make using health insurance better and much easier for Texas patients (see also Health Insurance).

The problem: Too often patients do not understand their health insurance information and cannot easily find the answers.

'We believe our patients have the right to know what's covered in their insurance,' said Josie R. Williams, M.D., TMA's president. 'Our patients also have the right to know which doctors and hospitals are in their network, how much extra they will have to pay for the health care services they receive, and why they have to keep paying more for health insurance.'

That is why TMA launched its grassroots outreach campaign, Patients' Right to Know. The goal of the campaign is to engage Texas patients in the effort to pass legislation that would reform health insurance.

Several state lawmakers have introduced important legislation that will ensure that patients have the right to accurate and current information on copays, deductibles, and health plan networks to make good health care decisions.

Health Insurance Code of Conduct Act of 2009

The first piece of legislation to bring needed improvements to the health insurance industry is the Health Insurance Code of Conduct Act of 2009. The measure was filed by Sen. Kip Averitt (R-Waco) and Rep. Craig Eiland (D-Galveston) in the Senate and the House as Senate Bill 1257 and House Bill 2750, respectively.

'We think it's about time health insurance companies treated our patients like valued customers, and keep the promises they make,' added Dr. Williams.

Health Insurance 'Soup Can Label' Bill

For many people, understanding which insurance to buy is difficult. So physicians wonder, what if patients could understand what's in their health insurance policy as easily as they can see what's in a can of soup? What if patients could compare two different health plans as easily as they can compare the calories in two different jars of peanut butter?

TMA's health insurance label plan, filed by Sen. Kirk Watson (D-Austin) and Rep. Senfronia Thompson (D-Houston), would do just that. SB 815 and HB 1932 would require a standardized format for health plan marketing materials that allows an 'apples-to-apples' comparison of health insurance coverage.

'Buying health insurance today is very complicated,' said Dr. Williams. She added that big insurance companies offer dozens of different plans, and cover different things. Patients' out-of-pocket costs can vary wildly. 'It is almost impossible to compare what each plan might mean to patients, their family, or business owners' employees, and we think it's time big insurance makes this simpler for patients.'

The Patients' Right to Know campaign calls on patients and physicians to help make health insurance more accessible and transparent. Among other tools, TMA created www.meandmydoctor.com, a Web site with a grassroots action center where patients can write their legislators in support of health insurance reform bills. Educational materials will be displayed in physician offices to inform and engage patients.

TMA is the largest state medical society in the nation, representing nearly 44,000 physician and medical student members. It is located in Austin and has 120 component county medical societies around the state. TMA's key objective since 1853 is to improve the health of all Texans.

Keywords: Health Insurance, Managed Care, Texas Medical Association.

This article was prepared by Managed Care Weekly Digest editors from staff and other reports. Copyright 2009, Managed Care Weekly Digest via NewsRx.com.