Have you ever received a medical bill that was greater than you expected? If so, you may be the victim of a surprise medical bill. These occur when you need a treatment or test that is not available in your network, or you receive treatment at an in-network facility from an out-of-network doctor. At the time of treatment, you may receive assurances that you will receive your in-network discount. However, when you receive your bill, you find that the provider charged you the out-of-network price.
Surprise medical bills can run to thousands of dollars, and patients report investing vast amounts of time to resolve the issue. Recognizing that this is a significant problem, legislators in both houses of the Indiana General Assembly have passed a bill to help protect patients against surprise medical bills. However, as reported by the Indy Star, lawmakers admit that this is only a first step and the bill does not resolve every issue.
What the proposed bill would do
If the bill becomes law, it would provide patients with at least a five-day grace period in which to decide whether to receive out-of-network services. Patients must also receive an estimate of what it would cost to receive the services in question so that they can make an informed decision. Failure to meet these conditions means that a provider cannot send the patient a bill exceeding the in-network coverage rate.
What the proposed bill does not cover
The bill does not make any provision for surprise medical bills resulting from emergency care. In a life-threatening situation, patients cannot schedule necessary treatment five days in advance. It also does not say anything about whether the insurer or the provider would have to assume the loss for the difference between the in-network and out-of-network rates.
Before the bill can become law, it needs review by the Office of the Attorney General and action by the governor.