Texas Attorney General Opinion issued April 13, 2021 negatively affects Reference Based Pricing plans in Texas.
Opinion No. KP-0367
QUESTION: Whether subsection 20.05(a)(5) of the Business and Commerce Code prohibits a consumer reporting agency from reporting certain information if the consumer is covered by a self-funded plan with a reference-based-pricing program (RQ-0385-KP)
OPINION: The subsection does not preclude Texas hospitals’ collection agencies from furnishing to a credit bureau information about an individual’s outstanding balance for medical bills when the employer has adopted a reference-based-pricing program that does not utilize a provider network.
FROM ATTORNEY
That was a really poorly crafted question. Most RBR plans have a network of physicians. It’s almost like the hospitals submitted the question.
FROM INSURANCE CONSULTANT
Looks to me like Paxton is probably right on the law, the Legislatiure got it wrong! Not much of a surprise there.
FROM INSURANCE CONSULTANT
Well, not a win this timed…..but we’ll fight on, right??
FROM RBP PLAN SPONSOR
That’s bad news for us. We need to get it fixed. I would assume someone will challenge that in the courts. It would go back to the legislative intent. This is a drafting error.
FROM ATTORNEY
The hospitals wrote that opinion. Bastards
