By R.A. Schuetz Updated 1:56 pm
CDT, Wednesday, October 10, 2018
The Texas Department of
Insurance fined Humana $700,000 for putting patients at risk of high bills in
Harris, Bexar and Travis counties.
Texas law requires that
insurance companies such as Humana ensure their benefits are reasonably
available to customers. However, the state concluded that Humana provided an
insufficient number of anesthesiologists in the three metro areas.
As a result, customers
couldn't get in-network anesthesia services at more than 20 hospitals and
surgical centers, including eight Houston hospitals. Humana insurance customers
needing anesthesia at those hospitals had no option but higher bills.
"Humana has agreed
to process these as in-network claims. Not one Humana consumer will pay extra
because of this network issue," Insurance Commissioner Kent Sullivan
said.
According to the state,
Humana's network had contracts with an adequate number of anesthesiologists in
January of 2018, but that changed when four contracts for facility-based
anesthesia serves were terminated by June.
"The Texas
Department of Insurance has now certified that the Humana commercial
facility-based surgical anesthesiology network is adequate," Humana's
regional media relations lead Marina Renneke said in an emailed statement. She
said the issue had been "unique to Humana's commercial health insurance
business in Texas" and did not impact Medicare patients.
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