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Insurance Consumer Advocate

Sha'Ron James


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Tallahassee, FL 32399-0308

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Surprise medical bills ban passes Florida Legislature on last day

News Article

March 11, 2016

Palm Beach Post

In a buzzer beater, Florida lawmakers passed consumer protection against surprise medical bills late in Friday’s final day of session.

One patient advocate said it protects consumers in a way she called the “first of its kind in the nation.”

Consumers like Joyce Trapp of Loxhatchee told lawmakers they “need help,” but following months of hearings and workshops HB 221 passed only after a series of battles that did not end until shortly before 6 p.m.

“The impact this legislation will have on Florida’s families is tremendous,” said state Insurance Consumer Advocate Sha’ron James.

The bill, which now heads to Gov. Rick Scott, limits charges consumers can face in situations where they have no real choice about using medical providers out of their insurer’s network. Unexpected consumer bills can pile up by the thousands not just in emergencies but also in other cases such as an out-of-network radiologist at an in-network hospital, bill supporters said.

The aim: Hold consumers “harmless,” meaning they would pay no more than the equivalent of in-network costs. Insurers and out-of-network providers would be required to work out payment differences on their own.

Some medical groups argued it gives insurers too much leverage to set prices too low. A spokesman for the Florida Society of Anesthesiologists on Friday evening called it “a giveaway to the insurance industry.”

The bill “protects insured consumers in the state from unfair surprise medical bills,” said Laura Brennaman, policy and research director for patient advocacy group Florida CHAIN (Community Health Action Information Network). “This is the first of its kind in the nation without imposing complex and prescriptive processes that removes the patient from the dispute resolution process between the doctors and the insurance companies.”

Florida’s Chief Financial Officer Jeff Atwater cheered the result.

He said the Legislature “found a finely-tuned and balanced solution to a multifaceted problem.”

Atwater continued, “While all sides of this health care community presented valid perspectives and strong opinions throughout the legislative process, I’m pleased that our legislative leaders kept consumers at the forefront of this conversation, ultimately removing them from this complex billing equation.”