Lincoln senator’s bill takes aim at ‘surprise’ medical bills

On Tuesday, the Banking, Commerce and Insurance Committee took testimony on Sen. Adam Morfeld’s legislation that aims to eliminate surprise balance bills.

“Imagine for a moment that you or your significant other has a medical situation which requires you to go to the emergency room,” Morfeld said.  “A few months later, you get a bill for thousands of dollars and a realization that while maybe the hospital is in network, but the radiologist or anesthesiologist is out of network.”

He said the bill would require facilities to tell patients whether they, their providers and services are in their insurance network.  But if you need emergency care and it happens to be from out–of–network providers, you would only pay for the in–network services covered by your plan.

Speaking in favor of the bill, Jina Ragland of the AARP of Nebraska said surprise billings are not uncommon.

“This may happen, for example, when they go to their in–network provider for services and get their blood drawn or an x–ray taken down the hall, only to have the blood sample sent to an out–of–network lab or the x–ray read by an out–of–network radiologist,” Ragland said.

She said the last thing someone recovering from a procedure wants is to receive a bill from an out–of–network provider or facility they didn’t know was involved in their care.

No one testified against the bill.  Some who support the bill’s intent did have concerns over some parts addressing transactions and what would be considered excessive charges.

“Who determines what excessive is?” said Michael Feagler of the Nebraska Hospital Association.  “We wonder if there couldn’t be terminology in that area.”

Others said it leaves out some responsible parties.

“The legislation really puts a lot of responsibility on the hospital and providers,” Bryan Health CFO Russ Gronewold said.  “But we really think the insurance companies really have a large part to play in the success of this.”

Sen. Morfeld said he’s open to working with any stakeholders about their concerns over the bill.  He said he’d like to see it passed this year or the end of next session.