Sometimes you don’t know from one day to the next who are your friends and who are your opponents. As pointed out in an article in the Austin-American, two groups with long-standing disagreements — doctors and trial lawyers — are teaming up to try to enact stiffer enforcement of a law that requires insurance companies to promptly pay medical providers
Here are excerpts from the article, titled “Tort reform foes team up to force insurance companies to pay promptly”:
Trial lawyers and doctors have a long history of acrimony at the Texas Capitol, much of it due to the years-long tort reform debate. But lately, many doctors and hospitals are putting aside hard feelings and are hiring trial lawyers to fight another Capitol powerhouse: insurance companies.
Doctors are being forced to align with people who can champion their cause, and strangely enough, it’s their former nemesis: the plaintiffs’ bar, said Kim Ross, the former chief lobbyist for the Texas Medical Association and a current health care consultant.
The unifying force is the state’s “prompt pay” law — a 2003 measure that requires health insurance companies to pay claims to medical providers and pharmacies within strict timelines, usually 30 days, or face having to pay interest and often serious penalties.
For the past decade, the lobbies for doctors and trial lawyers have fought each other head-on – usually over money.
The high water mark of the disharmony between the two groups might have been 2003, when the Legislature passed tort reform. Then, medical professionals cheered the law that they said allowed them to practice medicine without the threat of frivolous lawsuits. Lawyers, conversely, saw the law as a draconian piece of legislation that closed the courthouse doors to victims of medical malpractice by limiting noneconomic damages, such as pain and suffering.
Medical professionals, many of whom operate on tight margins, often haven’t gone after each slow or late payment. It just isn’t cost effective to try to independently find and collect small, unpaid claims, said Pam Udall, a spokeswoman for the Texas Medical Association. But when added up, all the small claims can amount to real money.
This is where the lawyers come in.
Ross said the trial lawyer/doctor alliance has significance beyond bringing two enemies together. The collaboration is emblematic of a growing conflict between insurers and the medical community, he said. At the root, doctors think insurers are actively looking for ways to deny coverage, while insurance companies say they shouldn’t be forced to pay for expensive and unnecessary services.
The insurance industry is likely to reach out to sympathetic lawmakers. Ross said he expects the insurance companies to try to get legislation passed during this year’s legislative session that would limit the amount of money, including penalties, that medical professionals can collect under prompt pay laws.
But insurers could be in for a tough sell. Lawmakers seem to want prompt pay laws on the books. A version of a prompt pay law has cleared the Legislature twice: It passed in 2001 only to be vetoed by Gov. Rick Perry, and then it came back in 2003, when Perry had a change of heart and approved the bill. He said at the time insurers that “game the system by dragging their feet” will pay stiffer penalties.
