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Sha'Ron James

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Proposal to Ban Balance Billing Continues to Weave Through Legislature

News Article

February 11, 2016

Sunshine State News

Legislation to ban balance billing is still making its way through the Florida Legislature, passing through its latest committee by a unanimous vote.

HB 221, sponsored by Rep. Carlos Trujillo, R-Miami, would make “balance billing” illegal. Trujillo says the issue is a widespread problem for people with PPO healthcare plans who head into emergency rooms, only to be slapped with an extra (usually very expensive) bill several months after checking out.

When patients go into a emergency room, they’ll often receive a bill from the hospital for medical care, but after they’re discharged from the hospital, patients will sometimes get “surprise” bills from doctors at the hospital who may have been out of network.

The surprise bill happens when insurance companies and medical providers can’t agree on a charge for a medical service, so the healthcare provider will bill patients for the entire difference. Sometimes, these bills can be pretty steep -- to the tune of thousands of dollars. Those who can’t enter into some kind of payment plan or pay the bill outright could be forced to enter into consumer bankruptcy, a dangerous predicament, says Trujillo.

“We should remove the consumer in all situations, not just for providers but for hospitals all along the way,” said Trujillo.

“We as a legislature must stand with the consumers of Florida...[stand against the special interests...the powerful associations that would undo...what the consumer advocate supported,” said Rep. John Wood we need to take a stand on our principles,” said Rep. John Wood, R-Winter Haven, who has been a fierce ally of Trujillo and the bill during this year’s legislative session.

Wood refers to large corporations like hospitals and ambulance agencies, who strongly oppose the legislation since they say it could become incredibly expensive for them long term. Instead, physicians, hospitals and ambulance agencies say the blame should be pointed at insurance companies who don’t pay enough for emergency medical services.

The bill’s Senate counterpart, SB 1442, sponsored by Sen. Rene Garcia, R-Hialeah, narrowly made its way through the Senate health policy committee earlier by a vote of 5-4, and will be heard in the Senate Banking and Insurance committee next week.

The two bills have gathered conflicting opinions from patients, insurance agencies and healthcare providers who each have stakes in the issue. Balance billing could potentially affect a third of insured Floridians who are covered under PPO plans.