the facts. We also think it’s important for Cigna’s in-network doctors to be part of the conversation through the use of the out-of-network form.” Cigna says it shared the form with the state and is working with regulators to implement what Drs. Netoskie and Watson called an “important consumer protection.”
TMA does not condone inappropri- ate use of out-of-network referrals. TMA and AMA ethics policy encourage physi- cians to disclose any ownership interests when they refer patients to entities out- side of their practices. At the same time, TMA policy opposes health insurance company policies or procedures that dis- courage or interfere with medically nec- essary referrals for out-of-network care by imposing requirements for physicians to obtain patient signatures, sign docu- ments disclosing ownership interests, make telephone calls, or obtain notifica- tion numbers.
THE PEOPLE OF TEXAS HAVE ALWAYS MADE US PROUD. YOU INCLUDED.
Frost is proud to salute the Texas Medical Association for all of its efforts throughout our great state.
frostbank.com (877) 862-4900
HHSC: Marketplace- Medicaid referrals “especially complex”
Leading up to the Oct. 1 launch of the federally run health insurance market- place in Texas, Medicaid officials warned that for at least the first few months, new federal rules could complicate their job of determining Medicaid eligibility for those referred from the exchange. Meanwhile, as this article went to
press, Gov. Rick Perry ordered new regulations on the “navigators” the Af- fordable Care Act (ACA) authorized to help people enroll in health insurance through the marketplace. Some lawmak- ers and consumer advocates complained the added criteria to be established by the Texas Department of Insurance (TDI) — including state registration, privacy training, and background checks — also could delay and complicate enrollment for the uninsured. ACA requires most individuals to have health insurance in 2014. It man-
November 2013 TEXAS MEDICINE 45
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