Sisolak signs bill to rein in "surprise billing"

[TexasTowelie]

Gov. Steve Sisolak signed a bill into law Wednesday that would clamp down on “surprise billing,” a practice that allows out-of-network health care providers to gouge patients in need of emergency care.

Assembly Bill 469 would limit the amount out-of-network providers can charge in such circumstances to no more than a patient’s insurance co-payment, co-insurance, or deductible. It also establishes a course of action for third party providers to transfer patients to an in-network hospital or independent center for emergency care within 24 hours, and procedures to work out payments between insurers and third-party providers.

If the now-out-of-network provider previously had a contract with the insurer, the legislation also leaves insurers on the hook to pay a percentage of the contracted rate.

“If you’re experiencing a medical emergency, the last thing you’re worried about is making sure the provider treating you at the nearest hospital is in your insurance network. If it’s not, you can be hit with an outrageously high bill for your emergency care without knowing it, even though you have health insurance,” said Sisolak. “No Nevadan should have to worry about getting hit with an unexpected five-figure medical bill for receiving emergency care that their life could depend on,” calling the bill “an important step” in making health care more affordable.

Read more: https://www.nevadacurrent.com/blog/sisolak-signs-bill-to-rein-in-surprise-billing/

[lark]

1. Until I retired, I worked for a physicians billing group and this is what we did.

We had physicians in about 5 hospitals depending on which year it was so we had a lot of these non-contracted issues. We met with the hospital administrators and came up with a policy that we didn't bill our patients at the higher rate. Since it was a manual intervention, the billers sometimes missed this, but my customer service reps. were trained to write off the difference when it was brought to their attention. Wiht HMO's, that meant we wrote off the entire balance, minus a normal co-pay. It was the right thing to do and I'm proud that we had a really good CEO who actually cared about our patients. I worked there until she retired and things started to change then I followed her out the door.