Texas Medical Board Withdraws Surprise Billing Rules

The Texas Medical Board is changing its tune about how to interpret Texas’ latest surprise billing legislation. Last week, controversy arose about rules written by the Texas Medical Board in the interpretation of Senate Bill 1264, which was meant to prevent patients from being involved in the balance billing process, were criticized for creating a large loophole for physicians to exploit. Critics said the rules would have put confusing paperwork in the hands of patients, with a potential result being that patients may sign away their protections under the new legislation. The Texas Medical Board said it would not have… Full Story

Most Texas Individual Marketplace Health Plans Are Getting Cheaper

On the individual marketplace, the average cost of health insurance is down 14 percent from 2018 to $508 per month, according to the 2020 Health Insurance report from LendingTree. Nationwide, the individual marketplace for health insurance has stabilized with decreased premiums, attracting companies like Oscar to return to North Texas and Blue Cross Blue Shield of Texas to enter the market. Enrollment in the marketplace peaked in 2016, with more than 1.3 million people selecting plans. In 2019, that number was down to just over a million. There are eight insurers in the Texas marketplace this year, including Blue Cross… Full Story

Texas Can Expand Coverage Without Expanding Medicaid – Here’s How

Texas remains one of 14 states in the country that has yet to expand Medicaid, as its Republican leadership has refused to accept more federal money for expanding health insurance to more of our state’s poor families. DFW’s hospitals are behind Medicaid expansion, in part because Dallas is the largest city with the worst insured rate in the nation. Nationwide, 5.7 percent of children don’t have health insurance, but in Dallas county, that number is 14.3 percent. A number of factors have also decreased the number of children in rolled in CHIP. Hospitals (via taxpayers and consumers) end up paying… Full Story

Texas’ Balance Billing Legislation May Be Threatened by Loophole

Consumer advocates are worried that a proposed rule could undo the protections in Texas’ balance billing legislation. After a law was passed this summer to keep Texas patients out of arbitration between providers and insurers when there are surprise medical bills, some worry that a loophole in the legislation will be used to confuse patients and increase balance billing. Stacey Pogue, a senior policy analyst with the Center for Public Policy Priorities, says that the Texas Medical Board is proposing a rule to implement the law that would expand the use of a section of the law for patients who knowingly… Full Story

D CEO Healthcare Breakfast Panel: What’s Next for Health Insurance

D CEO Healthcare Breakfast Panel: What’s next for health insurance?   The health insurance industry is one of the country’s most dynamic, complicated, and impactful. Ideas about the best way to provide healthcare are discussed everywhere from the highest echelons of government to living rooms across America. With increasing costs, changing risk and employer relationships, and new regulations, the insurance world is increasingly complex and important to employers, providers, patients, and everyone in between.   At D CEO, our Healthcare Breakfast Panels serve as an opportunity for health professionals to network, but more importantly, the panels are educational opportunities for our… Full Story

How Much Does it Cost to Treat Diabetes in Texas?

Diabetes treatment is becoming more frequent and more expensive, according to CDC data compiled by QuoteWizard, an insurance comparison service. The company analyzed the rise of diabetes and cost increases in insulin state by state from 2007 to 2017. The analysis found that the number of people with diabetes in Texas increased from 10.3% to 11.9% over the last 10 years, an overall 16% growth. Comparatively, the national diabetes percentage increased by 29% from 2007 to 2017. Medical costs nationwide increased 26% from 2007 to 2017, indicating that insurance premiums for diabetic treatment may likely follow the same rise. According… Full Story

Medicare-for-All: The DFW Hospital Perspective

What to do about the United States’ ever-expanding medical costs has been a key issue during the presidential primary season. Medicare-for-All, Medicare-for-more, Medicare-if-you-want-it, and a bevy of other healthcare policies have been key talking points for every serious Democratic presidential candidate. Steve Love is the CEO of the DFW Hospital Council, a 90 member hospital organization that helps hospitals collaborate and advocate for initiatives they value, and he says that while the hospitals want to be politically neutral and are for increased coverage, Medicare for all is not the answer. He calls it a “cry for help.” There is a… Full Story

Texas Health Aetna Takes Its Network Nationwide

Texas Health Aetna’s President and Chief Operating Officer Genevieve Caruncho-Simpson says the joint venture between insurer and provider is a total cost of care solution for the region utilizing virtual care, national coverage, and other innovations to bring down healthcare costs for North Texans. The organization covers 110,000 lives, and is working to reduce the pain points that plague the medical industry. Texas Health Aetna is making significant progress against the physician shortage, an over-reliance on emergency care care, and a significant population with chronic conditions, Caruncho-Simpson says. Embracing technology has been a key to the success. THA’s Anytime-MD has been… Full Story

Why Oscar Health Came Back to Dallas and What it Means for the Local Individual Market

The Affordable Care Act created subsidies for millions of previously uninsured Americans, and with those subsidies and potential members, new and established health insurance players waded into the space to see if they could make it work and grow their membership. But in the years that followed, the market proved to be tumultuous, and premiums jumped double digits for the first few years. Once millions of people who had not been receiving consistent quality healthcare had insurance, many medical issues were discovered; the pool was sicker than the average group of insured members. With the premium increases, 2016 saw many… Full Story

Naturally Slim Names Chief Revenue Officer

Dallas-based Naturally Slim has appointed Doug Layman as chief revenue officer to lead growth in the employer-sponsored space. Layman brings more than two decades of experience in the employer benefit space to the company. “Adding Doug to the team is a game changer in my mind,” said Rob Butler, CEO of Naturally Slim, via release. “His experience, track record of growth success, professionalism, and breadth of relationships are best-in-class and I feel fortunate we were able to add him to the team.” Layman has been in the employee benefits industry for more than 25 years as a strategic planning, business development,… Full Story