House of Representatives

Bills to End Surprise Medical Billing Advance


3/12/2020 1:24:00 PM

OKLAHOMA CITY – State Reps. Chris Sneed (R-Fort Gibson), Tammy Townley (R-Ardmore) and Marcus McEntire (R-Duncan) on Wednesday passed bills that would end surprise medical billing for Oklahoma residents.

 

House Bill 3388, authored by Sneed and Townley, and House Bill 3483, authored by McEntire, both passed the House of Representatives with votes of 92-3 and 95-0 respectively.

 

Sneed, Townley and McEntire have agreed to work together to ensure one piece of legislation gets through the state Senate and onto the governor to be signed into law in order to protect Oklahomans.

 

“Our goal is to eliminate all surprise medical bills for Oklahomans,” Sneed said. “We want to remove the patient from the middle, set benchmarks to determine the amount medical providers will get paid by insurance companies and put in place procedures to resolve payment disputes.”

 

A surprise medical bill often comes when an insured person goes to an in-network facility to get a covered procedure done, but an out-of-network provider actually provides services resulting in a bill not covered by the insurance company and hence a surprise to the insured. A balanced bill, on the other hand, is one which an insurance company says beforehand they are not going to pay the amount charged by the provider. This gives the insured the option to pursue treatment or not.

 

McEntire said he’s pleased with the work on this issue.

 

“Patients who have acted in good faith to pursue medical procedures they are assured are covered by insurance should be held harmless to these surprise bills,” McEntire said. “I believe the end product of our legislation will accomplish this and prohibit the practice of surprise medical billing going forward.”

 

Townley said, “We’ve worked hard over a long period of time with health insurance companies and health care providers to come up with a positive solution for Oklahoma consumers. I’m excited to move this legislation forward and look forward to the day when these medical patients are assured of the price they will be paying for their care.”

 

Both bills would prohibit health providers from charging a patient the difference between their fee and what an enrollee’s health insurance pays, and they make provisions for emergency services.

 

HB 3388 directs the state insurance commissioner to select a nonprofit organization to maintain a benchmarking database containing information on percentiles of billed charges from out-of-network providers and rates paid to in-network providers, in order to determine the usual, customary, and reasonable rate insurance carriers would be required to pay.

 

HB 3388 also directs that if an insured patient receives emergency services from an out-of-network provider, the patient will no longer be responsible for any amount greater than what they would pay in-network.  The bill would require arbitration in cases of disputed payment

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HB 3483 would require the State Department of Health to require health facilities to post on their websites information related to their contracts with insurers for services and a disclosure statement about patients’ potential risk of being balance billed. The measure would allow out-of-network providers and health insurers to request mediation to settle disputed claims.