Scheduled to be voted on the floor of the House — Tuesday, April 30:

 This is the “Silent PPO” bill in its fourth iteration; TABA has successfully quashed this legislation in the past three legislative sessions. This year, hoping to neuter our opposition, the bill omits the requirement that TPAs or their employer-clients register as PPOs based upon a single provider negotiation. But the current bill DOES include the untenable requirement that any Plan that enters into a PPO agreement abide by all the terms and conditions of the provider contracts that the PPO has entered into. So it subordinates the Plan Document, the Stop Loss contract, and all other contractual arrangements of the Plan to contracts between PPOs and providers that the Plan has not seen…was not a party to…and had no role in negotiating. Our nightmare…but a trial lawyer’s dream! Attorney Lane Odom has provided a formal opinion that this legislation would not survive a federal ERISA pre-emption challenge. And TABA met with the Governor’s office on Friday afternoon to ask the Governor to veto this legislation if passed. But we hope it won’t get this far. We hope you’ll join us in explaining to your representative that this is the last nail in the coffin of private PPOs. It is not good legislation. It is not good business. It will raise the cost of healthcare for Texas employers…and for Texans.  

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