Georgia lawmakers consider 2 solutions for surprise billing

Georgia lawmakers are looking at solutions to surprise medical billing, according to Bluffton Today.

The solutions are designed to protect patients from surprise bills that occur when they have a procedure or visit an emergency room at an in-network hospital but are treated by an out-of-network provider.

One proposed solution involves an insurer-backed proposal originating in the state House. Insurance Chairman Richard Smith's plan would require medical providers, if asked, to give patients information about which physicians will be part of a nonemergency hospital procedure, whether the providers are in-network and the potential fees they could charge, according to Bluffton Today.

Another proposal, introduced by state Sen. Chuck Hufstetler, is backed by physicians and primarily focuses on emergency room bills. The legislation would calculate insurers' payment to out-of-network providers using a formula that includes a benchmarking database from Fair Health, an independent, nonprofit organization with a database of 27 billion private healthcare insurance claims.

While physician groups support the Senate bill as a balance-billing solution, officials representing insurers argue that the database payment provision will increase healthcare costs, according to Bluffton Today. The House bill does not include a compensation formula.

 

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