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Surprise medical bills forum takes on issues consumers want solved

A Jupiter woman is contesting a bill of more than $23,000 involving trauma-team charges her insurer has refused to cover.

A Wellington man said his out-of-pocket costs in his health plan nearly doubled to $5,900 in one year.

A Port St. Lucie man said his bill for a drug test jumped $130 to $850 in one month.

Consumers from Palm Beach County and the Treasure Coast have joined others from across Florida to let a state advocate know about their problems with surprise medical bills ahead of a forum in Tallahassee Thursday.

Consumers can watch the event live by computer at The Florida Channel starting at 9 a.m.

The forum in Tallahassee organized by state insurance consumer advocate Sha’Ron James is designed to help shape debate after attempts to get a handle on the problem stalled in Florida’s legislature last spring. Last week, James called the timing “critical,” warning “the consumer is being caught in the middle of a battle between the insurer and the provider.”

Lawmakers are gathering in committees this fall ahead of the legislative session early next year.

She appeared at events this week in Palm Beach County, including a property insurance workshop hosted Tuesday by state Sen. Maria Sachs, D-Delray Beach, where some consumers raised health insurance issues as well. She is paid by the state to represent consumer interests in insurance matters.

James said she aims to find a “balanced” approach to a problem that ended in a stalemate amid fierce lobbying by insurers, medical providers and others last spring.

A key issue, as her website notes, is “unexpected charges related to medical services provided by non-network providers, known in the industry as ‘balance billing.’ This issue impacts medical providers, insurers and others; however, it is often the consumer who is left financially burdened by this form of unexpected health care cost.”

It happens when insurers and medical providers fail to agree, so they bill the consumer for the difference. It can occur in a wide range of situations, including emergencies where the consumer may have little control over whether someone is in a health plan or not.

Among the scheduled speakers is Georgetown University health policy analyst Jack Hoadley, who is expected to talk about how various states are trying protect consumers from unexpected charges.

For an idea of how it looks to a range of “stakeholder” groups, representatives from America’s Health Insurance Plans will join others from the Florida Medical Association, the Florida Hospital Association, the Florida College of Emergency Physicians and Florida CHAIN, a consumer advocacy organization.

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