Consumers Union fights scary surprise medical bills
Assistant Policy Analyst
The Huffington Post has laid plain the truth: it is terrifying how easy it is for consumers to get stuck with a surprise medical bill through no fault of their own. Take the story of Lisa Bettendorf. After having her face injured at home, Lisa went to an emergency department that was in her health insurance network. The usual surgeon was also in-network, but that surgeon was not on duty. Lisa had no idea the surgeon who helped her was out-of-network. The result? Lisa ended up having to pay about $10,000 for a situation she had no control over.
Stories like Lisa’s are why Consumers Union is fighting to protect patients from surprise medical bills. It is unfair that consumers are left out to dry for disagreements between health insurers and doctors. As our Director of Special Projects Betsy Imholz says in the Huffington Post , surprise medical bills, “should be between the plans and the providers. Let them figure that out. Duke it out. Just take the consumers out of the middle. […] It really shouldn’t be that hard, but frankly it really does get down to, in some cases, greed and people not wanting to diminish their income at all.”
We’re pressuring state and federal lawmakers to act to protect consumers from surprise medical bills, and regulators are taking notice. Center for Medicare and Medicaid Services (CMS) Director Andy Slavitt is trying to find solutions at the federal level. CMS is considering actions like requiring disclosure when an out-of-network physician will be providing services, protecting consumers from surprise billing in emergency situations, and establishing a payment model that pays a lump sum to all providers who participated in caring for a patient.
Several states are going further than CMS. Pennsylvania Insurance Commissioner Teresa Miller has proposed taking the consumer completely out of the middle of the surprise billing process. On March 11, the Florida Legislature passed HB 221 which removes patients from surprise medical bill disputes. Consumer advocates in Florida are hailing the legislation as the first of its kind. If Governor Rick Scott signs HB 221, Florida will join states like New York, Connecticut, and Texas in moving to end surprise medical bills. With your continued support and action, we will add more states to that list!