February 25, 2020–10:24 a.m.
Legislation to address so-called “surprise” medical billing has passed the Georgia State Senate with bipartisan support.
Legislators have been working for years to come up with a plan to address charges from out-of-network medical providers.
State Senator Chuck Hufstetler was the lead sponsor of Senate Bill 359.
He said if a patient shows up at the hospital in an emergency situation and the hospital is not in their network, the patient would only be responsible for co-pays and deductibles, and will no longer get a “surprise bill.”
The hospital and insurance company will settle all other charges among themselves.
“There is a fair and prompt payment method put in there to do that,” he said. “There’s some negotiation and then there is arbitration as the last step. Both sides send in their paperwork and an arbitrator decides what is fair.”
Hufstetler said the process is known as “Baseball Arbitration.”
“The arbitrator has to pick one of two numbers, either the insurer or provider’s number,” he added. “Both sides want their number picked so they come in with really close numbers and in most cases, they come to an agreement and don’t arbitrate. The goal is to not have arbitration; it’s to have them work it out, which they do in most of the instances we have seen in other states. The main thing is, the consumer is out of this at this point. The patient is no longer involved in the process. They’ve paid their deductibles and co-pays and they will not be getting surprise bills.”
The Senate Bill passed 54-0.
A similar measure is being considered in the State House.