January 22, 2019
OLYMPIA, Wash. – Insurance Commissioner Mike Kreidler is proposing legislation (HB 1065/SB 5031) for the fourth consecutive year to protect consumers from receiving a surprise medical bill.
More than 230 Washingtonians have shared their personal surprise billing stories with him over the last three years. This includes a Vancouver-area resident who received charges of $112,000 after seeking medical attention for her son during an emergency.
“Imagine how you’d feel if after doing everything we asked you to do – get insurance, make sure you go to an in-network hospital – you get an unexpected bill on top of what you expect to pay,” Kreidler said.
A hearing on Kreidler’s proposed legislation is scheduled for 1:30 p.m. Jan. 23 in the House Health Care and Wellness Committee. The meeting will be in House Hearing Room A of the John L. O’Brien Building in Olympia.
Jamie Hansen of La Center is scheduled to testify about her reaction to a $112,000 surprise bill resulting from seeking emergency care for her 15-year-old son last July.
Watch her story:
“I’ve heard too many stories from people who want to know how this can happen,” Kreidler said. “They don’t understand how this practice can be legal. They’re caught in the middle. The insurers and providers say they don’t believe this is fair, but so far they haven’t agreed on a solution to end this.
“Enough is enough. This year, we’re going to put consumers first.”
Surprise billing happens when you go to an in-network hospital or ambulatory surgical facility for a covered service but are treated by a medical provider who is not contracted with your insurance company. Because no contract exists between your insurance company and the provider, the provider is allowed to bill you the difference between what the insurer pays and what doctors believe the service is worth.
This can unexpectedly add hundreds to thousands of dollars to a bill beyond what an insurance plan will cover.
Kreidler’s proposal would prevent an out-of-network provider from sending a consumer a surprise bill for a covered service at an in-network hospital or ambulatory surgical facility. The provider and insurers must work out their payment issue. If they cannot agree, they go to arbitration and are forbidden from billing the consumer.
Currently, 11 states have succeeded in passing legislation that bans surprise medical billing.