June 17, 2020



(June 16, 2020) – The Knox County Hospital District (KCHD) has submitted a Prompt Payment Protection proposal to the Texas Department of Insurance (TDI) to consider supporting as the state agency tasked with regulating the insurance industry has begun formulating it’s 2021 agenda for the 2021 session of the Texas Legislature.

Knox County, which has a pending complaint at TDI against Aetna U.S. Healthcare to get payment on more than $12 million in claims going back to 2017, said that violations of the Texas Prompt Pay statues have become systemic and have forced healthcare providers into an endless loop of filing complaints at TDI and pursuing legal action simply to get paid for services rendered. KCHD has also called on state leaders to demand that TDI take a more aggressive stance in existing prompt pay laws.

we have come to the conclusion that it is imperative that the Texas Legislature address loopholes in the Prompt Payment statues currently in the Texas Insurance Code. Attached is a summary of our proposals which we think would help restore the original intent of the prompt pay requirements.

“It has been almost 20 years since Texas adopted its historic prompt pay measures. In the ensuing decades, insurance carriers have used a variety of means to steadily erode the enforcement of this critical measure which ensures that rural hospitals like ours get paid in a timely fashion,” Stephen Kuehler, KCHD CEO, said. “Our proposed Prompt Pay Protection measures are much needed for critical care providers like Knox County which is the only hospital available to the residents of our county.”

“We are grateful that TDI has solicited provider input as it makes plans for the 2021 Texas Legislature,” Kuehler added. “The COVID-19 pandemic has further exposed just how vulnerable our rural healthcare system is. We are already reaching out to other rural providers and look forward to working collectively with TDI to get this situation fixed in 2021.

“I have no doubt that healthcare will be front and center in 2021,” Kuehler said. “Rural providers better be at the table or we’re going to be left out.”

According to Kelly Dawson, attorney for the Knox County Hospital District, the current situation with Aetna demonstrates how routine violations of the Prompt Pay statue have become.

“Aetna is clearly in violation of the Texas Prompt Payment statute. These are clean claims that have gone unpaid for two years. TDI, as the regulatory agency for the healthcare insurance industry, needs to hold Aetna accountable,” Dawson said. “If they don’t, we will have to spend more time and money in the courts just to get paid.”

Recent reports have indicated that many of the state’s rural providers have no more than 30 or 60 days of operating funds in reserve and strict enforcement of the Prompt Pay laws (which require payment within 60 days) is a critical consideration.

About Knox County Hospital District:

Knox County Hospital District provides healthcare services for residents of Knox County and surrounding areas. The hospital district offers a wealth of medical services, including 24-hour emergency care, advanced radiology services, a clinical laboratory, physical therapy, patient education and more. The Knox County Hospital is a 25-bed acute care critical access facility located in Knox City, Texas which is 78 miles north of Abilene. The District also operates two rural health clinics, an outpatient retail pharmacy, home health, emergency medical services (EMS), a nursing home and durable medical equipment (DME) services.

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