BCBSTX Emergency Room Claims Policy Proceeds Without Changes From TDI

A Blue Cross Blue Shield of Texas policy that has garnered controversy officially went into place on Monday. The policy implements a review process for HMO members that could leave those members on the hook for their entire bills if they visit an out-of-network ER for a non-emergency.

In May, the Texas Department of Insurance got the insurer to delay implementation of the rule for 60 days so that TDI could meet with BCBSTX representatives to learn more about the plan. BCBSTX members were first notified of the policy in April. A spokesperson for the insurer said Wednesday that no changes were made after the TDI review.

In a statement, the company said it believes “this thoughtful, multi-step review process will provide protection for our members from inappropriate billing, egregious charges and fraud, waste and abuse by out-of-network emergency department.”

It said that over the last two months it “diligently worked with the Texas Department of Insurance, providing all requested information regarding” the process.