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Bill to rein in surprise medical billing advances

FRANKFORT, Ky. — Legislation to offer patients some protection from surprise medical bills passed the state Senate Wednesday.

“There are many factors that contribute to surprise billing,” said Sen. Ralph Alvarado, R-Winchester. “Some will place the blame on insurance companies. Some will place the blame on providers. It all depends on whom you ask. But while we are trying to figure out who to blame, patients are stuck in the middle of the problem – often with large medical bills.”

The measure Alvarado sponsored, known as Senate Bill 150, seeks to stop the practice by requiring insurers to cover surprise billing, sometimes called balanced billing. It happens when a patient receives medical care – often unwittingly – outside of their insurer’s network. Subsequently, the doctor or hospital bills the patient for the amount insurance didn’t cover.

Alvarado characterized SB 150 as a consumer protection bill. He said surprise billing was a dubious exercise of cost shifting from insurers to patients.

A second provision of SB 150 would require the state insurance commissioner to establish a database of billed health care service charges. A final provision would provide a dispute resolution program for medical insurers and providers to work out their differences over these out-of-network charges.

Sen. Rick Girdler, R-Somerset, stood to speak against the bill. He cited a fiscal impact statement prepared for the bill that estimated SB 150 would increase individual premiums for health benefit plans up to $9 per month.

“The people that are going to suffer … is the consumer,” he said.

Sen. Tom Buford, R-Nicholasville, stood to explain his “yes” vote on SB 150. He noted the self-funded Kentucky Employees’ Health Plan already covers surprise billing for its nearly 265,000 members.

“If we are going to enjoy that benefit, the citizens of Kentucky should share the same,” he said.

Sen. Wil Schroder, R-Wilder, stood to explain his “no” vote on SB 150. He said what was desperately needed was broader reforms to empower health care consumers through such measures as transparent pricing of procedures and drugs.

“Today I filed Senate Bill 265 that I believe offers a better solution in the context mentioned,” he said.

Alvarado said SB 150 wasn’t a hastily drafted bill but the results of three years of investigation.

“I wish to remind the members of the Senate that a successful bill for surprise billing should only make one group happy – and that is the patients we are trying to protect,” he said. “If other stakeholders are a bit uncomfortable, then we have a good compromise on this issue.”

SB 150 passed by a 30-3 vote. It now goes to the House of Representatives for its consideration.