For Consumers

Kreidler bill would end surprise billing for hospital emergency services

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January 18, 2016

OLYMPIA, Wash. – Insurance Commissioner Mike Kreidler is proposing legislation to protect Washington consumers from surprise emergency services bills that can add hundreds to thousands of dollars in unexpected costs.

Surprise or balance-billing can occur when a patient receives emergency services from a hospital that is in a health plan’s network. In addition to paying the health plan’s expected co-payments and deductible, the patient gets a surprise medical bill for being treated by doctors that a patient never knew were not in the network.

House Bill 2447 (leg.wa.gov), requested by Kreidler and sponsored by Rep. Eileen Cody, D-34th District in Seattle, would free patients from these billing disputes. Under the proposal:

  • If patients receive emergency care from their health plan’s approved hospital, they would pay only the expected charges.  
  • Any disputes over contracts or out-of-network fees would be worked out between the insurer and the medical provider or facility.

 

The public will have a chance to weigh in on Kreidler’s proposal at a hearing before the House Health Care and Wellness Committee at 1:30 p.m. Jan. 20 in House Hearing Room A in the O’Brien Building at the state capitol in Olympia.

“Consumers have been caught in the middle of these disputes for too long,” said Kreidler. “We told them to get health insurance and they did. And when faced with a medical emergency, they went to their health plan’s hospital. After playing by the rules, many are left facing surprise medical bills for hundreds or thousands of extra dollars.”

“This is an issue that I have been concerned about for some time,” Rep. Cody said. “I believe that the approach offered by the insurance commissioner is fair and balanced for providers and insurers while ultimately protecting the consumer.”

Kreidler added: “Surprise billing could happen to anyone, and it typically happens after the most vulnerable times in a person’s life. What’s so frustrating is that people believe they’ve done everything right. They made it through a medical crisis only to discover that now they have a financial crisis – through no fault of their own. Our bill is straightforward: it takes the patient out of the equation.

“If there’s a discrepancy in billing charges between the health insurance and a hospital or its out-of-network provider, they need to work it out between themselves personally or through arbitration. The consumer should be held harmless. This is a protection that is long overdue.”

Learn more about surprise medical billing

Read real stories of people impacted by surprise billing

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