Surprise, Unexpected Medical Bills!

Posted by Emerald Coast Medical Association on Dec 21, 2018 8:00:00 AM

The recent legal changes increased national attention to financial difficulties arising from patients receiving surprise, unexpected medical bills has led to a group of insurance, business and consumer groups announcing they have joined forces in an attempt to create solutions to reduce the frequency of this occurrence.

With potential changes including patients being notified when care is considered out-of-network or prior knowledge to charges along with alternative potential medical options and their costs being discussed, this new legislation has the potential to greatly alter the methods and efficiency at which medicine is currently practiced. Other guiding principles in this legislation include a policy to protect patients from increasing premiums as a result of policies enacted to protect them from surprise bills and a federal standard for payments to out-of-network doctors to help protect patients in self-funded health plans. The nine member coalition leading the charge in creating these new regulations consists of the following organizations: America’s Health Insurance Plans, National Business Group on Health and Consumers Union, American Benefits Council, the Blue Cross Blue Shield Association, the ERISA Industry Committee, Families USA, the National Association of Health Underwriters and the National Retail Federation.

There has been much debate on who is truly at fault for these surprise medical bills. A common practice in hospitals called balanced billing has been recently put at received a majority of the blame where patients are financially responsible for the difference between the hospital and insurer perceived cost of care.

Hospital groups stating that this coalition has incorrectly blamed them for these surprise bills have challenged this theory. American Hospital Association CEO Rick Pollack and American Hospitals President and CEO Chip Kahn emphasized in a joint statement a priority of hospitals and health systems is to eliminate surprise bills. The importance of the alliance of consumers, health insurers, employers, and hospitals working together was also brought to the forefront as a solution to prevent these unexpected charges according to these two high ranking officials in the hospital system.  

Continuing with the different viewpoints of this problem, a group of physicians earlier this year also formed a multispecialty alliance regarding the problem. The Physicians for Fair Coverage was created and has been pushing for more widespread adoption of legislation. This coalition has been noted to place a majority of the blame on the insurers.

The creation of these various coalitions will hopefully continue to lead to discussions regarding surprise medical bills and will ultimately end in a solution that will benefit all parties involved.

Original Article -

Topics: Medical Law, Doctor-Patient Relationships

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