Texas Healthcare in Light of Harvey

Posted on  August 30, 2017

 

Our hearts and prayers are with the many people who are currently suffering in Texas. In addition, we recognize and thank the many people who live in Texas as well as many others who have traveled to Texas along with the many organizations that have pitched in to try to alleviate this unfathomable catastrophe.

Ultimately, and unfortunately, the healthcare needs of Texas residents will only increase because of Harvey. Accordingly, the Texas Department of Insurance has issued two relevant bulletins that are meant to ease some of the almost certain difficulties that Texans are likely to encounter in seeking to access healthcare.

Commissioner’s bulletin # B-0012-17 as well as # B-0014-17, while currently only opinions that are advisory/guidance in their current form, seem to contemplate issues that invariably are a consequence of Harvey.

Recognizing that many insureds, enrollees or certificate holders could be forced to evacuate their residences and healthcare service areas, resulting in many storm victims being without necessary health care or dental care, the Texas Department of Insurance SUGGESTS that during the duration of the Governor’s disaster area proclamation, claims for out of network medical or dental care, whether for emergency or nonemergency treatment, should not be denied. Furthermore, the bulletin goes on to seek a relaxation on claim filing deadlines, while on the other hand reminding insurance companies and HMOs regarding prompt payment of claims that are presented with respect to catastrophic events. Finally, the bulletin seeks a waiver of requirements for insureds to obtain pre-authorizations, referrals, notification of hospital admissions or medical necessity reviews during the duration of the Governor’s proclamation.

The second bulletin seeks allowance for 90-day supplies of prescriptions.

There are reports that the state is also taking steps to ease the ability of doctors from other states to participate in the Harvey relief efforts by allowing healthcare providers employed by a hospital who are licensed and in good standing in another state to be allowed to practice medicine in Texas until the government lifts the suspension or until the disaster declaration is revoked.

It is important to note that the bulletins set forth above are advisory in nature. If there are complaints from insureds regarding noncompliance with these bulletins, however, it is within the purview of the Texas Department of Insurance to mandate compliance with same.

These moves will invariably ease some of the burden on Texas residents as well as allow out-of-state physicians to more easily help.

Let us all hope that this catastrophe is brought under control as soon as possible, while recognizing that tens of thousands of people’s lives will be negatively impacted and it will probably take years for the impact of Harvey to be stabilized.

Once again, our thoughts and prayers are with our fellow citizens in Texas, and our gratitude is with the first responders, volunteers and organizations that have given so generously and selflessly.

 
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