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Lawmakers seek way to end 'surprise' medical bills

State senators are working on a proposal to cut down on unexpected medical bills. So-called "surprise billing" by out-of-network providers has caught a lot of patients off guard.

Posted Updated

By
Laura Leslie
, WRAL Capitol Bureau chief
RALEIGH, N.C. — State senators are working on a proposal to cut down on unexpected medical bills. So-called “surprise billing” by out-of-network providers has caught a lot of patients off guard.
Sen. Joyce Krawiec, R-Forsyth, said she's heard numerous complaints from people who get medical care at a hospital or clinic only to find out later that their insurance doesn't cover it.

"You may have X-rays, a radiologist and an anesthesiologist if you have a procedure, and then maybe, months later, you're hit with all of these bills coming in, and you have no idea what they are," Krawiec told members of the Senate Health Care committee on Thursday. "That's when you learn that those providers were not in network."

Even though those third-party providers may work at a hospital or clinic that’s in someone's insurance network, they may not be part of it. Patients often don’t find out about that until after the fact.

"One [woman] had $18,000 worth of out-of-network billing," Krawiec said. "She called my office crying to my legislative assistant for a long time, explaining what all she was going through and how the creditors were coming after her. That should not happen."

Senate Bill 505 would require clinics or hospitals to let patients know 72 hours in advance of a planned procedure if they’ll be using any out-of-network providers. In emergency cases, the facility would have to notify the patient as soon as reasonably possible.

Ryan Blackledge, director of government relations for Greensboro-based Cone Health, told lawmakers that federal law requires that an emergency patient must be treated or stabilized first. making it difficult to meet that notification standard.

"If someone's coming into the emergency department, we cannot do anything to discourage them from seeking care, including talking about prices," Blackledge said.

Federal regulators are also planning to take action on surprise billing, but those rules won't be in place till next year, at the earliest.

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