Surprise medical bills: Law signed as advocate credits Post readers

Gov. Rick Scott on Thursday signed 20 bills including a ban on surprise medical charges — consumer protection that shoots Florida to the national forefront on the issue as a state advocate credited Palm Beach Post readers with playing an especially engaged role.

“The involvement and feedback from folks in Palm Beach County was crucial in highlighting the face of the issue,” said Florida Insurance Consumer Advocate Sha’Ron James. “As a result of the Post’s interest in the issue, we received many phones calls and messages from consumers who had experienced surprise medical bills.”

HB 221 puts new limits on what is sometimes called “balance billing.” It means consumers cannot be charged more than the equivalent of in-network charges in emergencies and other situations where the patient has no real choice — such as an out-of-network anesthesiologist for a scheduled procedure at an in-network hospital.

In a public meeting last fall, James cited examples including a Boca Raton woman who said that she stunned to be billed for more than $80,000 by a surgeon out of her insurer’s network, though the hospital was in network. The woman said she had to liquidate a retirement account.

Others reached out as well, helping state officials understand how the problem was blindsiding ordinary people. A Jupiter family told of being hit with of more than $20,000 in out-of-network charges.

A Loxahatchee law enforcement officer and his wife talked about more than $10,000 in out-of-pocket payments and more than $6,000 in collection notices, even though they had insurance. “We need help as consumers,” Joyce Trapp urged legislators in a Post story.

A similar legislative effort stalled a year before, but personal stories helped make the issue more difficult for lawmakers to brush aside — despite heavy lobbying pressure from interest groups who opposed it. The bill passed in the final hours of the session March 11.

“Floridians sent a powerful message to state lawmakers to pass this legislation, and we’re pleased that they listened,” Betsy Imholz, special projects director for Consumers Union, the advocacy arm of Consumer Reports, said Thursday. “We encourage other states to follow Florida’s lead and pass strong, comprehensive legislation that protects consumers from balance billing and the surprise bills that come from it.”

The governor also signed 19 other bills on Thursday, including measures promoting transparency in health care pricing and a bill that lets customers of state-run Citizens Property Insurance Corp. see all offers from private insurers, not just one at a time.

As for the surprise medical bills measure, Florida Chief Financial Officer Jeff Atwater of North Palm Beach called it “an incredibly consumer-friendly piece of legislation” with “a balanced solution to the complex issue of medical billing.”

That does not mean everyone is happy. The bill exempts ambulance services, who lobbied to be excluded after arguing local taxes might have to rise if they could not charge out-of-network rates.

Other medical providers expressed deep concern.

“What we ended up with was the insurers, experiencing record profits already, getting handed the ability to unilaterally set physician payment rates,” Jay Epstein, chairman of legislative affairs for the Florida Society of Anesthesiologists, said in March. “What undoubtedly will result is the need for physicians to litigate what is bound to be dramatic underpayments.”

For their part, consumer advocacy groups hailed it as a huge victory Thursday because it forces insurers and medical providers to settle disputes on their own — and leave consumers out of the middle.

“For too long, consumers have been trapped between insurance networks and out-of-network physicians,” said Laura Brennaman, policy and research director for Florida CHAIN (Community Health Action Information Network). “With the law signed today consumers, who are forced through no fault of their own to receive care from an out-of-network physician, will be protected from surprise balance bills.”

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