Georgia measures aimed at surprise medical billing run into back-and-forth

Georgia lawmakers are in intense talks to reduce surprise medical bills for people with individual insurance plans.

A state House bill that appeared headed for a big vote has been sent back to committee. A sister bill has passed in a Senate committee after contentious exchanges.

Unexpected medical bills for people who thought they were insured can happen for different reasons. The legislation moving through the House and Senate deals with perhaps the most common occurrence: A properly insured patient goes to a hospital. The hospital may or may not be in the patient’s insurance network; but within the hospital he or she is treated by an independent contractor who is not part of the patient’s insurance network. Then that doctor sends the patient a separate bill for whatever he or she thinks the patient should pay.

On Tuesday, House Bill 888 narrowly passed the House Special Committee on Access to Quality Healthcare but ran into criticism for compromises it contained. Rather than let it go toward the House floor for a vote, House officials later sent HB 888 back to committee for more work.

One big point of contention: hospital bills and emergencies. The House bill dealt with surprise bills from out-of-network doctors. Previous versions also dealt with out-of-network hospitals, at least in medical emergencies, but arguments over that provision led the bill’s sponsor to remove it from the bill.

State Rep. Todd Jones, a Republican from south Forsyth County, said he voted for HB 888 despite his reservations.

“We’re nibbling around the edges as opposed to actually cutting it up and saying, ‘We have to digest the idea of how do we handle a surprise emergency facility visit,’ ” Jones said. “At the end of the day you don’t have a choice when it’s an emergency situation.”

In the second measure, Senate Bill 359, which the Senate Health and Human Services Committee passed Wednesday, hospitals would be taken into account for emergencies.

A patient still would be in trouble if he or she went to an out-of-network hospital for a non-emergency. The patient would be deemed to have “chosen” a non-network doctor if he or she gave consent in writing and orally in advance of receiving the medical services and was told an estimate of the potential charges. The medical office wouldn’t have to give the patient any time to consider and could get his or her consent just before the service was provided.

The bill's sponsor, Sen. Chuck Hufstetler, wanted patients to get the notice 48 hours in advance but ran into opposition.

“The 48 hours I have begrudgingly taken out because there are people that feel that that’s impractical,” Hufstetler told the committee. “And I’ve got assurances that it will still work but that just isn’t practical in all cases. So that is no longer there.”

The bill passed the Senate Committee unanimously.