Surprise medical bills occur when patients receive care at a facility that is in their insurance company’s network, but they are seen by an out-of-network provider. Since the out-of-network provider does not have to adhere to contractual, in-network rate agreements, they are able to charge the patient for a remaining balance after the insurance company submits its portion of the bill.
Mr. Kreidler said in a news release that his proposal would bar out-of-network providers from sending surprise bills for a covered service at an in-network facility. He said the provider and insurers would have a chance to resolve their payment issue, but if a resolution isn’t reached, the parties would move to arbitration and be prohibited from billing the patient.
A hearing on Mr. Kreidler’s proposed legislation is slated for Jan. 23 before the House Health Care and Wellness Committee in Olympia, Wash.
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