Surprise medical bills ban survives tense fight

medical billsPatient advocates cheered the advance to the Florida Senate floor Thursday of a bill designed to stop consumers from getting hit with surprise medical bills, though not without a tense amendment fight some feared could scuttle the whole thing.

“We are very optimistic that the bill will pass the floor in both chambers – and the consumers of Florida will have a great victory,” said Laura Brennaman. She is policy and research director for the advocacy group Florida CHAIN (Community Health Action Information Network).

The bill is designed to stop consumers from being hit with surprise bills, sometimes tens of thousands of dollars, by medical providers out of their insurer’s network. The issue is sometimes called balance billing.

The ban applies to emergencies and certain other situations — a non-network radiologist, say, in a scheduled procedure at an in-network hospital — where the consumer has no realistic choice to select a network provider. It requires insurance plans and non-network providers to work out their differences but hold consumers responsible for no more than the equivalent of in-network charges.

An amendment to SB 1442 by future Senate president Joe Negron, R-Stuart, would have required insurers to pay for certain medical procedures they authorized even if consumers stop paying premiums. “This does protect consumers,” Negron told the Senate appropriations committee.

Insurance groups including the Florida Association of Health Plans indicated they opposed the amendment but did not explain their position in the hearing. Sponsor Sen. Rene Garcia, R-Hialeah, said he advised them not to speak in the interests of conserving time.

In a statement to The Palm Beach Post later in the day, the Florida Association of Health Plans said, “Under the proposed amendment an individual could receive three months of free health insurance coverage every year and never have to pay a premium.” That could eventually drive up health costs for all policyholders, the group argued.

“The Florida Association of Health Plans and its member plans would like to thank Senator Garcia for his leadership on this issue and look forward to the final passage of this good consumer legislation on the floor of the Senate,” president Audrey Brown said in a statement.

The amendment was initially declared passed on voice vote, but a roll call vote reversed that verdict.

“Sen. Negron’s amendment was consumer friendly, but it was packaged in a manner that threatened the balanced support by the insurance industry and the health provider community for the main issue eliminating surprise medical bills,” Brennaman said.

Groups who have often been on opposite sides of the debate, such as the Florida Medical Association and the Florida Association of Health Plans, have indicated support for the core bill. But not every part of the medical community is necessarily thrilled, including some specialist groups who earlier voiced concerns the bill gives too much leverage to insurers to set payments too low.

Ambulance services were removed from the bill earlier this session. The debate ended with no bill  at all  a year ago.

A similar measure  in the House awaits a vote in the full  chamber. The legislation still has ground to cover before the finish line but some supporters saw Thursday as the single biggest hurdle to get over.

“The actions of the committee today confirms the Senators’ commitment to this consumer-focused public policy,” said Florida Insurance Consumer Advocate Sha’Ron James. “I believe we have a very good chance of passing a comprehensive ban on balance billing, which is what we set out to accomplish.”

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