“The bills also protect insured patients in non-emergency situations who receive care at in-network hospitals from out-of-network physicians or other providers when they have no ability or opportunity to choose an in-network provider,” said Laura Brennaman, the group’s policy and research director. “This is a scenario that currently happens with hospital-based contracted providers like anesthesiologists, radiologists, and pathologists.”
She offered an example: “So if you went to an in-network hospital and planned to have your hip replaced by an in-network orthopedic surgeon – but the hospital assigned you to an out of network anesthesiologist and your x-rays were read by an out of network radiologist – under HB221 & SB1442, you would also be protected from surprise balance bills from these hospital based providers. I have stories from about 100 consumers in Florida who received bills in the amounts of thousands of dollars for this type of out of network care. We need the protection provided by this fine proposed law.”
Original post: A ban on surprise emergency medical bills cleared its final Florida House committee Wednesday, and is headed to the chamber floor in a form close to what passed a Senate committtee a day earlier.
The aim of HB 221 is to prevent consumers from getting unexpected bills — sometimes tens of thousands of dollars — when they are treated in emergency situations by medical providers out of their insurance plan’s network. It is a problem sometimes called “balance billing.”
“I am thrilled!” said Florida Insurance Consumer Advocate Sha’Ron James.”The amount of collaboration and compromise that has taken place on behalf of Florida consumers is unprecedented.”
James held a workshop on the issue last fall after hearing from from consumers and others from Jupiter, Boca Raton and around the state.
Groups often on opposite sides of the debate during the last two years, including the Florida Medical Association and Florida Association of Health Plans, waived comment in support of the measure Wednesday.
Under the legislation, consumers could not be billed more the equivalent of in-network co-pays and deductibles in emergencies, and must see greater transparency and disclosure in non-emergency situations, supporters say. It provides that medical providers and insurers can work out disagreements in a dispute-resolution process or in court, but the intention expressed by sponsors is to “hold consumers harmless.”
The Senate version, SB 1442, faces one more committee stop. The latest versions of the legislation do not mention ambulances, potentially leaving consumers vulnerable to surprise charges there. Many county-run ambulance services do not join insurer networks, arguing local taxes might have to rise if they were forced to do so.