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Pennsylvania proposes end to surprise medical bills

Written by Ben Allen, General Assignment Reporter | Feb 8, 2016 4:23 AM
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(Harrisburg) -- The state is trying to end a practice that can leave patients with bills running into the tens of thousands of dollars.

Let's say you go to an in-network hospital or clinic.

You might expect to pay your co-pay and little else.

But when an out-of-network doctor or specialist comes into the room, they can bill you at higher rates - sometimes as much as $30,000.

It's called balance billing, and the state Insurance Department is trying to stop it.

Commissioner Teresa Miller is floating a plan to require insurers and providers to work out the issue.

"We're really taking the consumer out of that situation where they may see a surprise balance bill. Really, the bottom line for consumers is they don't have to worry about getting these surprise balance bills going forward," says Miller.

Miller says the department will take public comment on the proposal through the end of February.

"So I do expect that we're going to be hearing more from those entitities [health insurers and providers like hospitals] and frankly we've been reaching out to them and have indicated that we'll be happy to talk further about the proposal because we're anxious to hear their thoughts about what we've put forward."

Miller says her staff looked at how other states handle balance billing, and incorporated some of the ideas they found.

She says she's talked with members of the State House Insurance Committee, and is hopeful the proposal may get some attention from the Legislature. 

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