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Insurance Consumer Advocate

Sha'Ron James


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Mailing: 200 East Gaines St.
Tallahassee, FL 32399-0308

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(850) 413-3089
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A new proposed law could mean big changes for surprise hospital bills

News Article

February 12, 2016

WFTV 9

ORLANDO,Fla. — Help could be on the way for patients who get hammered with surprise bills after emergency medical care.

Action 9 has been exposing "out of network" hospital bills for 5 years. One man was penalized more than $50,000.

There’s now a proposed law to ban those charges and its winning support. This reform proposal protects consumers.

These medical bills come out of nowhere. You're fully insured but hospitals or doctors not part of your health plan's network can hit you with huge fees.

An air ambulance flight cost anOsteenwoman $30,000.

A medical chopper company billed Ashlynd Anderson of Clermont $25,000.

Both women were fully insured but the emergency transportation was out of network so they had to pay sky high rates.

“It's ridiculous how much they charge people,” said Anderson.

Since 2011, Action 9 investigated 8 cases where families were slammed with surprise bills.

An ambulance rushed heart attack patient, Dan Lessard, to an out of networkhospital so insteadof paying a few thousand he was hit for $46,000.

Now reform legislation is working its way through Florida legislative committees.

According to the legislation, patients would be held harmless during emergency treatment and could only be billed discounted in-network rates.

Florida's Insurance Consumer AdvocateSha'RonJames says it’s needed. “If you have a PPO you can expect to receive an unexpected bill and we just don't think that’s fair.”

Under the proposed law, if providers and insurance companies could not agree on rates they would be forced into binding arbitration but the patient gets the discount.

“There are a number of lawmakers who agree with us that consumers need to be protected,” said James.

Several medical groups oppose it claiming insurance companies don't pay emergency providers fair rates.

The patients from the cases Action 9 investigated disagree.

“It's an outrage.”

The reform legislation has passed two key state committees so far.

Consumers are also hit with surprise bills for out of network routine care and that's not covered by this plan.