An effort to end “surprise billing” of medical charges in Georgia appears about to pay off.
The state Senate’s Health and Human Services Committee unanimously passed legislation Sunday aimed at unexpected medical bills that can add up to thousands of dollars and bankrupt families. Sunday’s vote came one day before the General Assembly resumes a 2020 legislative session interrupted three months ago by the coronavirus pandemic.
House Bill 888, which the Georgia House of Representatives passed overwhelmingly in March, would require insurers to cover emergency services a patient receives whether or not the provider is a participant in the patient’s insurance coverage network, said Sen. Chuck Hufstetler, R-Rome, sponsor of a similar bill the Senate passed in February.
Typically, unexpected out-of-network charges come from specialists including radiologists or anesthesiologists.
In the case of non-emergency services, the bill requires out-of-network providers to notify patients in advance of what the charges will be, Hufstetler said.
Disputes over a bill between an insurer and provider would trigger an arbitration process overseen by the state Department of Insurance, which would contract with outside arbitrators to decide the final bill.
Hufstetler said the arbitration would be conducted “baseball-style,” meaning the insurer and provider would each set a number, and the arbitrator would choose one or the other. Such a system would lead to more realistic proposals by parties to an arbitration, he said.
“If both sides want their number picked, they won’t put out a number from left field,” he said.
Lobbyists for Georgia insurers, hospitals, physicians and consumer advocates have been working for five years to come up with language all sides could agree on.
On Sunday, representatives of the Georgia Hospital Association (GHA) and the Medical Association of Georgia (MAG) testified in support of the legislation as a good compromise.
“This bill will take patients out of the sometimes stressful negotiations that come with out-of-network providers,” said Anna Adams, vice president of government relations for the GHA.
“We’re glad to be close to the finish line on this thing,” added Derek Norton, MAG’s director of government relations. “It’s a great bill for patients.”
Sen. Ben Watson, R-Savannah, the committee’s chairman, said he considers the surprise billing legislation among his top five priorities for the final 11 days of the 2020 session. It could get a final vote on the Senate floor as early as Wednesday.