SOUTH Fla. gov signs law shield­ing pa­tients from sur­prise bills

Modern Healthcare - - REGIONAL NEWS - —Har­ris Meyer

The move­ment to pro­tect con­sumers from sur­prise med­i­cal bills won a ma­jor vic­tory last week when Florida Repub­li­can Gov. Rick Scott signed a bi­par­ti­san bill that will ex­empt pa­tients from hav­ing to pay bal­ance bills from out-of-net­work providers in cer­tain sit­u­a­tions.

The new law will ap­ply to pa­tients who go to a health­care fa­cil­ity in their health plan net­work and in­ad­ver­tently re­ceive ser­vices from a non-net­work provider. Pa­tients would be re­spon­si­ble for pay­ing only their usual in-net­work cost-shar­ing.

Plans and non­par­tic­i­pat­ing providers would have to work out pay­ment for those ser­vices through a state-ar­ranged, vol­un­tary dis­pute res­o­lu­tion process, with a penalty as­sessed to the party that re­fused to ac­cept an of­fer that was close to the fi­nal ar­bi­tra­tion or­der. The ne­go­ti­a­tion would be based on the usual and cus­tom­ary rate for the par­tic­u­lar ge­o­graphic area. Dis­putes could be taken to court. The bill would ap­ply only to PPO-type plans, since Florida al­ready bars bal­ance-billing pa­tients in HMOs.

Consumer groups were de­lighted. “We com­mend Gov. Scott for sign­ing HB 221 to pro­tect Florid­i­ans from un­fair med­i­cal bills,” said Laura Bren­na­man, pol­icy di­rec­tor for the Florida Com­mu­nity Health Ac­tion In­for­ma­tion Net­work. “With the law signed to­day, con­sumers who are forced through no fault of their own to re­ceive care from an out-of-net­work physi­cian will be pro­tected from sur­prise bal­ance bills.”

Scott also signed ac­com­pa­ny­ing leg­is­la­tion to in­crease price trans­parency in Florida hos­pi­tals. “This leg­is­la­tion is an im­por­tant first step as we con­tinue to ad­dress the high costs hos­pi­tals pass on to pa­tients and their fam­i­lies,” Scott said in a writ­ten state­ment. The gov­er­nor launched his trans­parency ini­tia­tive af­ter do­ing bat­tle last year with Florida hos­pi­tals over Med­i­caid ex­pan­sion, which hos­pi­tals fa­vored and he op­posed.

Florida Gov. Rick Scott

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