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Wash. Lawmakers Move to Heal Surprise Billing Burn

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Monday, March 18, 2019   

OLYMPIA, Wash. – Washingtonians facing a health emergency rarely have time to consider if the local hospital or doctor is in their insurance network.

But they can be hit with steep bills if they aren't covered.

A bill in the Washington state Legislature seeks to address this issue. One of the most common types of surprise billing is known as balance billing, where patients go to a hospital in their network but get care from a physician who is out of network.

Dr. Nathan Schlicher is an emergency room physician and a member of the American College of Emergency Physicians. The group is working on the issue of balance billing.

Schlicher says patients shouldn't be caught in the middle of this issue.

"As emergency physicians, we believe that if you feel like you have an emergency and a reasonable, prudent layperson would believe that, then you should seek care and we'll worry about the finances later," he states.

One in five patients nationwide who go to the ER is hit with a surprise bill, according to a 2017 study in the journal
Health Affairs.

House Bill 1065, which currently is in the Senate, would bar patients from being billed for out-of-network services if they're fully insured and at an in-network hospital or need emergency care.

This is state lawmakers' fourth attempt to address surprise billing.

Health care advocate Jason Resendez, a board member of Consumers for Quality Care, says health care is a key issue for voters, especially in Washington state.

According to a survey commissioned for his group, 60 percent of Washington voters say health care is the most important issue on their minds and 63 percent say they are frustrated by unexpected hospital bills.

Resendez says hospitals and insurers should deal with this issue, not patients.

"And that's really where this issue should be addressed is between the insurer and the hospital system, figuring out what is fair and what is fair compensation and taking that burden away from the consumer and patient," he states.

The state Senate held a hearing on HB 1065 last week and an executive session is scheduled for Wednesday. Efforts to address surprise billing are also emerging at the federal level.


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