|Date:||November 08, 2017|
|Source:||Palm Beach Post|
The message to legislators from a state health advisory board is simple: Stop ambulance services from billing consumers for whatever is left over after insurance pays, a practice known as “balance billing.”
That can leave consumers with surprise bills of hundreds of thousands of dollars after they call 911, The Palm Beach Post has reported.
Consumers in an emergency “are not able to make an informed decision or negotiate at arm’s length about the cost of the transport,” wrote Carol Ostapchuk, executive director of the Florida Health Insurance Advisory Board, in a letter to state insurance commissioner David Altmaier.
The letter, dated Oct. 20, summarizes the board’s findings. It was released Tuesday by the Florida Office of Insurance Regulation.
Altmaier “generally supports a prohibition on balance billing because the practice can bring harm to consumers,” a spokeswoman said.
As chairman of the advisory board, the commissioner did not vote on the matter, she said.
The advisory board, whose function is to advise state officials on matters of public policy, recommended lawmakers adopt rules similar to those in a bill that passed a year ago to limit what providers can bill consumers in certain situations where they have no realistic choice of providers. Example: An out-of-network anesthesiologist at an in-network hospital.
The law limits consumer bills to the equivalent of “in-network” charges, though it excluded emergency medical transportation. A state working group has been meeting over the last year on ambulances and is expected to issue a “white paper” by December.
Most public and private ambulance services choose not to join insurer networks, because they say reimbursement is often too low. If they are effectively forced to join networks, representatives warned, it could mean higher taxes or cuts to service.
“If you don’t have balance billing, then you’re asking the taxpayers of Stuart to pick up the difference,” Stuart FireRescue ChiefDavidDyal told a state working group last month.
Ambulance officials say insufficient payment by insurers or rising deductibles inhealth plans are often to blame, but insurers argue there has to be some incentive for ambulances to negotiate contracts, rather than bill consumers for whatever amount they choose.
As Post has reported since 2012, consumers like Penny Farrow of Boynton Beach feel frustrated they pay for insurance and taxes for county or city ambulance services, yet still get charged for amounts they don’t understand after they call 911. She found found a $600 bill for a short ground ambulance trip “outrageous.”