A bill that would stop patients in Georgia from receiving unexpected medical bills unanimously passed the Senate on Monday.
Senate Bill 359, proposed by Sen. Chuck Hufstetler, R-Rome, is one of several bills filed this legislative session that pushes for consumer protection in health-care billing.
SB 359 would require insurance companies to treat out-of-network emergency room bills the same as in-network bills. An average of 13 percent of emergency visits in Georgia in 2017 resulted in at least one out-of-network charge, Kaiser Foundation researchers found.
“Two-thirds of people are worrying about being able to pay a bill and medical bills are the number one reason for bankruptcy in the state of Georgia,” said Hufstetler, adding that 78 percent of the public “have demanded that we do something about it. I think the other 22 percent just haven’t seen it yet, or they would be doing the same thing.”
In an emergency, patients might be routed to a medical provider for emergency treatment that is not included in their insurer’s network. Insurance companies may not pay for those services or opt to pay only a portion of the listed price. A second invoice then is sent to the patient for the services that are not covered.
Hufstetler’s legislation, dubbed the Surprise Billing Consumer Protection Act, would exclude patients who signed paperwork agreeing to pay the additional costs for out-of-network care.
Patients who are covered by a private company and union health plans also are excluded because of the guidelines under the federal Employee Retirement Income Security Act.
“I will throw one caveat in there, is that the ERISA plans are not covered by funded, large company plans, simply because we have no legal authority,” Hufstetler said.
The Georgia Department of Insurance would review the prices of the bills that are protected under the Surprise Billing Consumer Protection Act and maintain an “all-payer health claims database” to keep track of pricing points.
Insurers also would have the option to dispute the price point with the department through an arbitrator.
Hufstetler told the Senate on Monday he has the support of the Medical Association of Georgia, insurance companies, the Georgia Hospital Association and nurse organizations on SB 359’s language.
Hufstetler, who is an anesthetist, has proposed another bill aimed at surprise-billing protections in this legislative session, and he also has worked with state Rep. Lee Hawkins, R-Gainesville, on a duplicate bill in the House.
SB 359 now will go to the House for consideration.
