AARP, the nation’s strongest voice for people age 50 and older, today announced support for state legislation to protect consumers against surprise bills from non-network health care providers.
Surprise balance billing occurs when individuals seek medical care from providers and facilities they believe are in their health insurance plan’s network, but unknowingly receive a service from an out-of-network provider. They may then be responsible for paying a large portion or all of the cost.
LB569, the Out-of-Network Consumer Protection, Transparency and Accountability Act introduced by Sen. Adam Morfeld, requires advance disclosure to patients about the in-network status of health care facilities, providers and services along with other safeguards. In an emergency situation where out-of-network services are provided, patients would pay no more than they would for in-network services covered by their health plan.
According to a February 2018 Kaiser Family Foundation analysis, nearly one in five inpatient admissions includes a claim from an out-of-network provider. Jina Ragland, advocacy director for AARP Nebraska, urged members of the Banking, Commerce and Insurance Committee to move LB569 to the full Legislature for consideration.
“Our health care system is already complicated and consumers who do their best to navigate it in good faith deserve to be protected from costs that cannot be predicted and therefore cannot be avoided,” she said. “The last thing people need to get is a bill in the hundreds, or thousands of dollars, from an out-of-network provider or facility that the consumer may not have even known was involved in their care.”
The Kaiser 2018 Health Tracking Poll found that when given a list of possible worries, unexpected medical bills tops the list including other health care costs such as premiums, deductibles and even drug costs, as well as other household expenses. Four in ten insured adults ages 18-64 say there has been a time in the past 12 months when they received an unexpected medical bill and one in ten say they received a “surprise” medical bill from an out-of-network provider in the past year.