Bills to prevent surprise medical charges get support of health providers

Jan. 16--INDIANAPOLIS -- Doctors, businesses and medical consultants turned out Wednesday in support of legislation that would bar hospitals and other health care providers from springing surprise bills on patients.

House Bill 1004 and Senate Bill 3 would prevent hospitals and other health care providers from charging patients for services that are outside of the care networks covered by their health insurance. Votes were postponed until next week on both bills, which were heard in House and Senate health committees Wednesday, to allow time for likely amendments.

Dr. Brian Blase, who served from 2017 to 2019 as special assistant to President Trump for healthcare policy, applauded SB 3.

"It is confusing and unfair for consumers whose facilities are represented in network and then indigenously receive surprise bills from a provider or a service that was out of network," Blase said.

SB 3, authored by Sen. Ed Charbonneau, R-Valparaiso, would require healthcare providers to give patients a good faith estimate about the cost of their procedure at least five days beforehand, with the exception of emergency room bills. Under the bill, healthcare providers who are out of network but are providing services at an in-network facility cannot charge more than the insurance company agreed to pay the in-network provider.

Dr. Alexander Choi, the president of Anesthesia Consultants of Indianapolis, testified in both the Senate and House committees that he liked the idea of ensuring patients know the costs, but wants to see changes in the legislation.

"The concept I fully support. In fact, our practice has been doing that for years," he said.

But he said there were interpretation issues that could allow for possible arbitration, and problems with billing the out-of-network companies

Terry Metzger, the chief financial officer for St. Vincent Health, supported the bill, and told lawmakers about insurance misunderstandings among patients.

"We have to take patients out of the middle," he said.

The House bill, HB 1004, would reduce out-of-network prices to the lower in-network costs. Rep. Ben Smaltz, the Auburn Republican who authored the bill, said the focus is on the suffering Hoosiers.

"An in-network facility may not bill an in-network patient out-of-network fees," he said.

Getting a surprise bill, he said, could have both financial and health consequences.

"The next time they need help with their health, they may be much more reluctant to seek the care that they need," he said.

Blase, who also is a senior research fellow on health care policy and spending and budget Initiative at the Mercatus Center in Virginia, called HB 1004 a step in the right direction, citing recent studies that show Indiana's hospital prices and spending are higher than other states.

"The prices in Indiana are 30% higher than other states in the study, 40% higher for outpatient care," he said.

Annah Elliott and Zach Roberts are reporters for TheStatehouseFile.com, a news website powered by Franklin College journalists.

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