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Tuesday, June 1, 2010

TMA WINS BIG IN PHYSICIAN RATING RULES

It took the Texas Department of Insurance (TDI) nearly a year to write rules implementing a key piece of TMA’s health insurance reform package that the Texas Legislature approved in 2009. And TDI came through with flying colors by making sure that health insurance companies play as fairly as possible in their various schemes to rank physicians on cost and quality. As mandated by House Bill 1888 by Rep. John Davis (R-Houston) and Sen. Robert Duncan (R-Lubbock), the new rules require health plans to conform to nationally recognized standards and guidelines when ranking or tiering physicians. Additionally, it gives physicians extensive due process protections. One of the most important changes requires the health plans to inform physicians ahead of time when they are gathering data for performance rankings. TDI agreed with virtually all of the recommendations TMA made when it adopted the rules.

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