Texas regulators warn health plans: pay on time or pay penalty

Article Abstract:

The Texas Dept of Insurance is warning health insurers in the state to pay its physicians on time or face stiff penalties. A new state law requires health plans to pay physicians, hospitals and other health practitioners within 45 days of receiving a complete claim. The department has received complaints from physicians alleging slow payments. Insurers that fail to pay their claims in a timely manner face penalties that range from fines to revocation of their license.

Health Regulation, Management, Laws, regulations and rules, Compensation and benefits, Texas. Department of Insurance

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Texas physician says his HMO deselection violates ADA

Article Abstract:

Texas rheumatologist Jorge C. Zamora has filed a complaint with the Equal Employment Opportunity Commission, claiming that his 1995 deselection from the HealthTexas Medical Group was in violation of the Americans with Disabilities Act (ADA) provisions. Zamora claims he was fired for excessive requesting of procedures and tests for his chronically ill patients. Title 1 of the ADA prohibits employer discrimination against anyone associating with the disabled.

Outpatient Care Facilities, Outpatient Care Centers, Health Regulation NEC, Cases, Ambulatory care facilities, Clinics, Zamora, Jorge C., HealthTexas Medical Group

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Solo, small-group physicians at risk

Article Abstract:

The American Medical Association surveyed 4,100 physicians and concluded that physicians' financial health could be adversely affected by the capitated payment arrangements commonly used under managed care contracts. Most independent and small-group doctors do not carry the reinsurance or stop-gap provisions they need to avert catastrophic financial losses, the survey found.

Direct Health and Medical Insurance Carriers, Health Plan Administration, Economic aspects, Finance, Health care industry, Insurance, Capitated payment systems (Medical care)

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