April 15, 2016
Members of preferred provider organizations will receive protection from surprise billing by medical providers outside their networks under a new law signed this week by Gov. Rick Scott.
The bill stemmed from complaints by patients who went to hospitals within their networks for emergency care and were then stunned to receive large, unexpected bills from doctors who were not members of the patients' insurance networks.
The new law extends protections previously in place for HMO members to members of PPOs and exclusive provider plans, or EPOs. It bars patients from being billed for emergency services or covered non-emergency services provided in a hospital or other facility in the patient's insurance network for any amount that exceeds the co-insurance, co-payment or deductible contracted between the patient and the insurer.
For non-emergency care, hospitals will have to post names and links of all contracted insurers, as well as names and contact information of all practitioners and practice groups under contract with the hospital. Patients will be given statements that services may be provided by out-of-network providers and that they should contact practitioners to determine to which networks they are contracted.