Freestanding ERs ask state to offer outpatient services across Texas

Texas Politics

AUSTIN (Nexstar) — The Texas Association of Freestanding Emergency Centers is asking the Health and Human Services Commission for permission to offer out-patient services.

“Right now our hands are tied, we can’t provide anything except emergency services,” TAFEC President Kevin Herrington explained, “We want that changed.”

Herrington said freestanding ERs are fully equipped and fully staffed to handle these services. “CT, an X-ray, routine laboratory work, even the flu shot,” Herrington said, but state law limits these freestanding facilities to only using those resources in emergency cases.

“We want that changed. It is very frustrating to have a service and say, ‘Sorry, we can’t help you, you’ll have to drive to somewhere else,” Herrington said.

But the group is facing pushback from the AARP and the Texas Association of Health Plans.

TAHP President Jamie Dudensing said she questions why they’re making this proposal during the pandemic, when out-patient centers are already hurting.

“Many of those primary care doctors and specialists are actually, you know, having a hard time because of a loss of patient volume. You know, they’re they’re not needing somebody else to come in and take away more of it,” Dudensing said.

Blake Huston with AARP Texas also seemed skeptical.

“Well, really, is there a shortage of facilities and providers that are filling those roles right now? I’m not sure there is,” adding that he thinks these freestanding ERs will have to prove there is a need in order for HHSC to approve their request.

Herrington said, though, that the freestanding ERs offer more of a sense of comfort to those who might fear coming in due to COVID-19 exposure.

“We are intimately understanding COVID and how to wear the appropriate PPE and deal with patients and families to ensure that they’re well protected as well as our staff,” he said.

But Dudensing has another major concern: pricing.

“You know, we all saw the $10,000 price tag for COVID test, that should have cost less than $200,” she said, pointing to a larger issue of price gouging across the state. Huston agrees.

“We’ve tracked a history of issues with different freestanding ERs where we’ve seen misleading advertising, price gouging, unexpected out of network care, just generally surprised medical bills. And when I see the industry asking for more authority to do things beyond their current scope, it really makes me worried about what that could mean for patient care and the cost of patient care,” Huston said.

Herrington said those headlines can sometimes be misleading, however.

“We can clarify, it, almost all the time, is the insurance company sending information to the patient called an explanation of benefits or EOB. That is inaccurate and reflects out of pocket expense that is not realistic for that patient,” he explained, adding that anyone with questions about costs can reach out to one of their patient advocates.

HHSC has 60 days to respond to the petition.

It’s not clear if the HHSC even has the authority to waive state law to let freestanding ERs expand this type of care.

Rep. James White, (R) Woodville, filed a bill last session that aimed to allow these facilities to care for non-emergency patients. That bill did not make it to a floor vote.

He has filed a similar bill again for the upcoming session.

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