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Special to The News-Courier—
KNOX CITY—The Knox County Hospital District, continuing its legal battle with Aetna, has submitted a Prompt Payment Protection proposal to the Texas Department of Insurance (TDI) in anticipation of the upcoming session of the Texas Legislature.
KCHD also has called on state leaders to demand that TDI take a more aggressive stance in existing prompt pay laws.
The hospital district reported last week that violations of the Texas Prompt Pay statues are now systemic and have forced healthcare providers into an endless loop of filing complaints at TDI and pursuing legal action simply to get paid for services rendered.
“It has been almost 20 years since Texas adopted its historic prompt pay measures,’ Stephen Kuehler, KCHD CEO, said. “In the ensuing decades, insurance carriers have used a variety of means to steadily erode the enforcement of this critical measure which ensures that rural hospitals like ours get paid in a timely fashion.
“Our proposed Prompt Pay Protection measures are much needed for critical care providers like Knox County, which is the only hospital available to the residents of our county.”
Kuehler said the hospital is grateful that TDI has solicited provider input as it makes plans for the 2021 Texas Legislature. “The COVID-19 pandemic has further exposed just how vulnerable our rural healthcare system is, and we are already reaching out to other rural providers and look forward to working collectively with TDI to get this situation fixed in 2021.”
Kelly Dawson, attorney for the Knox County Hospital District, said violations to the Prompt Pay statue have become routine in Texas. “Aetna is clearly in violation of the Texas Prompt Payment statute,” he said. “These are clean claims that have gone unpaid for two years. TDI, as the regulatory agency for the healthcare insurance industry, needs to hold Aetna accountable. If they don’t, we will have to spend more time and money in the courts just to get paid for services provided.”