Medical System

Developments in the Texas Prompt Payment Act of 2003

Posted by on Jun 22, 2015 in Uncategorized | 0 comments

Doctors and other medical professional are historically slow-paid by health insurance companies that they service. There was a time when insurers paid slower than Medicare. As a result, these professionals refused to renew their contracts or limited their services, making it more difficult for people with health insurance to get the care they need.

This prompted the Texas state legislature to come up with the Texas Prompt Payment Act of 2003. This imposed strict timelines and penalties for insurers that failed to pay on time for legitimate invoices. Naturally enough, insurance companies brought their legal weight down to bear on the law, delaying implementation for nearly a decade. Medical service providers finally have the law on their side to ensure prompt payment of services.

However, according to the website of the Texas prompt pay lawyers at Williams Kherkher, there are fresh wrinkles in the legal landscape. One bill from the Texas House of Representatives (HB 1433) and another from the Senate (SB 1166) are proposing to amend the law in significant ways. HB 1433, for example, proposes a two-year statute of limitations and significantly lower caps for civil penalties. Currently, the lowest cap for payments delayed for at least 31 days is $100,000. The bill reduces it to $5,000.

On the other hand, SB 1166 proposes new exceptions for the penalty provisions that will make it harder for the burden of proof heavier for the plaintiff. It also proposes to that the 18% interest imposed on the insurer is only for the unpaid amount and limits the award of attorneys’ fees.

These are proposed changes to the law, and if they pass, they will have a significant impact on claims. However, it is not yet part of the law, so this is the time to make a claim. If you are currently suffering from the effects of long-delayed payments from an insurance company, you should not delay consulting with a competent prompt pay lawyer in Texas.

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