“Surprise billing” bill fails in Georgia House

(PHOTO contributed by Atrium Medical Center)

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(PHOTO contributed by Atrium Medical Center)

Legislation described as an attempt to address surprise bills sent to patients who thought they were covered by insurance failed in the Georgia House Thursday night by a vote of 77 to 78. The bill was House Bill 84.

Since Thursday was Crossover Day, when bills must pass at least one chamber to survive the session, that leaves one surprise billing measure standing. The Senate passed Senate Bill 56, which would go further to address surprise billing than HB 84.

Surprise billing happens when properly insured patients go to a hospital in their insurance network, for example, but then find out that some doctor or service within that hospital was not in network. Then the patient gets a bill for the full price the out-of-network doctor decides to charge, and the insurance compay may pay little or nothing.

The House bill would have left the burden on patients to find out which doctors in their upcoming procedure were in network. But it would have mandated that when they ask, the information be provided to them. It also would have set up a mediation process.

SB 56 would establish a database of prices that the patient’s insurance company must pay, rather than leaving the patient to cover whatever the doctor says is owed. Insurance companies say those prices are too high. That bill now goes to the House. It hasn’t been assigned to a particular committee yet.

If SB 56 goes to the House Insurance Committee, it could have trouble.

Rep. Richard Smith, R-Columbus, sponsored HB 84, and he also chairs the House Insurance Committee. Surprise billing measures that go further to ensure payment of the surprise bills have historically stalled there.

Responding to a question from the floor on why HB 84 didn’t go further, Smith raised concerns with the constitutionality of bills that force insurance companies to pay a certain amount that they have not contracted to pay. That issue, Smith said, can be heard in a subcommittee of his panel: “We will have a hearing but a hearing only.”