- Associated Press - Thursday, February 16, 2017

ATLANTA (AP) - Nobody likes receiving unexpected medical bills, especially when they followed all the rules and thought they paid what they owed. But one in five people who go to emergency rooms find themselves in precisely that situation.

It’s called surprise billing: when patients go to hospitals that accept their insurance, but then end up receiving a bill for out-of-network services.

The Senate Health and Human Services Committee, which has tackled the problem for more than a year, finally reached a potential solution Thursday, unanimously passing a bill that would require the insurer and health care provider to resolve disputes over surprise bills, without involving the patient.

If the two parties couldn’t come to a resolution, then the case would be decided by the Department of Insurance acting as a third party. The final amount of reimbursement would be determined using a cost database run by a nonprofit organization.

The bill also would require hospitals and healthcare providers to make it easier for consumers to educate themselves about how to avoid surprise bills.



Sponsored by committee chairwoman Sen. Renee Unterman, R-Buford, Senate Bill 8 now moves on to the Rules Committee, which determines when bills get a floor vote.

“None of the people in this room like this (bill) and that’s a good thing,” Unterman said, referring to various lobbyists who attended the meeting.

But even as they passed the bill, committee members expressed frustration with what they said was a lack of cooperation from the interested parties.

Committee member Sen. Greg Kirk, R-Americus, complained that insurance companies and doctors had not provided adequate information about how much insurers currently pay doctors, which he said lawmakers need to create a fair reimbursement benchmark for resolving disputes between the two groups.

“We can’t compare apples to apples,” Kirk said.

The groups had said such information is proprietary.

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