California congresswoman to share surprise-billing story at hearing

U.S. Rep. Katie Porter of California plans to share her surprise-billing experience during a May 21 congressional hearing on the issue, according to the Los Angeles Times.

Ms. Porter, a Democrat elected in November, received a surprise medical bill last year after her appendix burst.

At Irvine, Calif.-based Hoag Hospital — an in-network facility — she had an appendectomy and spent an additional five days in the hospital on IV antibiotics, Ms. Porter told the Times. She said her Anthem Blue Cross plan covered about $55,000 worth of services, and she had a $250 copay.

Weeks later, though, she said she received a $3,231 bill from the out-of-network surgeon, leaving her with $2,800 in out-of-pocket costs.

"It's not a special story because I'm a member of Congress. It's actually that this is such an ordinary experience," Ms. Porter told the Times. "As we’re trying to encourage Americans to buy insurance in the face of higher premiums, we're trying to encourage employers to continue to provide coverage. To then not have the insurance system working to protect people from unexpected problems is a real problem."

Her remarks come as federal lawmakers are working on legislation to end surprise medical bills.

Republicans and Democrats in the House and Senate have introduced preliminary proposals. Proposals include limiting a patient's cost-sharing and out-of-pocket responsibilities for out-of-network emergency care to in-network amounts, as well as an arbitration process to settle payment disputes between the health plan and the hospital or healthcare provider.

Another proposal, from Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., is expected to be released as soon as this week, and multiple congressional hearings are expected on surprise medical bills, according to the Times.

 

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