Posted: | October 6, 2015 05:33 PM |
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From: | Senator Judith L. Schwank and Sen. Jay Costa |
To: | All Senate members |
Subject: | Surprise balance-billing |
In the opaque world of health care billing and pricing, surprise balance-billing is an increasing problem. In the near future, Senator Costa and I will introduce legislation to end the practice. Typically, surprise balance-billing occurs here when an in-network provider's health care services include services by another provider outside of the patient's insurance network. The patient usually is unaware that the service is not covered until receiving a separate bill later, in an amount that can easily range into the tens of thousands of dollars or more. To make matters worse, the cost might not be communicated to the patient for months and endanger his or her ability to appeal the charge. With some 45 million Americans behind on medical bills, and half of all bankruptcies caused by them, patients should not risk being saddled with bills for services they reasonably understood would be covered by their health insurance. More than a dozen states now protect HMO health care consumers and nine protect PPO consumers from out-of-network bills. Many are similar to Pennsylvania in limiting this protection to emergency room visits, but increasingly states are taking a more appropriate position that restricts surprise balance-billing generally. New York adopted a best practice statute this year that is the model for our legislation. Our proposal will :
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Introduced as SB1158