LASATA: Let’s end surprise medical bills

Published 7:27 am Friday, November 29, 2019

The health care system in our country can often be confusing. When people have a medical issue, many are left wondering what procedures their health insurance plan covers, or what hospital system or physician is approved by their insurance company to be considered “in network.”

As members of these insurance networks through health insurance plans, people receive medical coverage for various procedures when they are sick or otherwise need care. Typically, patients seek treatment, pay any required amounts under their health plan, which usually come in the form of copayments and deductibles, and the insurance company covers the rest.

Insurance companies make contracts with health care systems who make contracts with providers for administering health care services. Sometimes, services provided do not result in a covered health care service, because either the service itself is not covered or because the provider rendering the service was not in the network of the patient’s plan. Unfortunately, this can lead to surprise medical bills that are as expensive as they are unexpected.

These bills often come at the worst times and because they are unexpected and costly, leave people in the lurch, grasping for answers and the money to pay the bill. This is a problem in need of a solution, and I am happy to support a bipartisan effort to help fix it.

The proposed legislation would help improve transparency in the health care payment and billing process and help customers make more informed decisions. It would require that health providers get written consent from a patient before any nonemergency care is given that would result in a bill not covered by their insurance.

The plan would also help provide financial protections when patients seek out-of-network emergency care by setting limits for so-called reimbursement rates, which would prohibit out-of-network providers from charging unreasonable fees.

The health care industry is a complex web of deals and contracts that often leaves patients confused and stuck with surprise bills. I think it’s time we did something to help make the system easier to understand and more affordable.

The legislation is currently making its way through both the Senate and House of Representatives, and I am hopeful that they will become law soon.