Texas legislators and the Dallas Morning News have both joined the chorus of voices calling for greater regulation of how freestanding emergency rooms present themselves and bill patients. Recent news articles and editorials in the newspaper warn consumers about the high cost of mistaking a freestanding emergency room for an urgent care center, citing a $3,000 bill for out-of-network emergency room services vs a $200 charge for the same services at an urgent care center. As urgent care insiders and healthcare experts know, many insurance companies balk at paying high fees from freestanding EDs, leaving the patient with a hefty bill they never expected. The paper also says one out of every five visits to the facilities results in “surprise billings.” In the Texas state senate, Bill 507 proposes to give consumers recourse when they receive unexpected medical bills. If passed as written, it will expand the Texas Department of Insurance’s mediation system to include all types of out-of-network providers treating patients at in-network hospitals and other facilities, including freestanding EDs. The bill would also allow mediation for emergency care balance bills over $500 at any healthcare facility, whether in or out of network. On a related note, it seems the difficulties in the freestanding ED model are catching up to at least one of that industry’s major players; the stock price of Adeptus—which went for $25 a share at the time of its initial public offering before shooting up to $125—closed at $2.40/share on March 9.
More Pressure to Rein in Freestanding Emergency Room Billing in Texas