Surprise Billing Legislation Approved by House Health Policy Committee

Posted on November 07, 2019

On Nov. 7, the Michigan House Health Policy Committee approved legislation to address the issue of surprise medical bills. Also referred to as balance billing, surprise medical billing occurs when patients are unexpectedly held responsible for the cost of care that was provided by out-of-network healthcare professionals without the patient’s knowledge, either as part of their treatment at an in-network facility or as the result of treatment provided during an emergency. The package consists of House Bills (HBs) 4459-4460 and 4990-4991 and was introduced by Reps. Roger Hauck (R-Mt. Pleasant) and Frank Liberati (D-Allen Park).

Michigan Capitol BuildingFor emergency situations, or in cases where a patient does not have the opportunity to choose an in-network provider, HB 4459 would set insurance reimbursement at the greater of 150% of Medicare or the average in-network accepted rate for the patient’s health plan. HB 4460 would require healthcare providers to obtain the patient’s written consent 14 days before proceeding with nonemergency services that would result in a surprise medical bill, and HBs 4990 and 4991 would establish penalties for providers that don’t comply with the law.

The MHA is committed to protecting patients from surprise medical bills while ensuring adequate access to healthcare services. Due to MHA advocacy efforts, several changes were made to the originally introduced bills that will ensure Michigan hospitals can continue to negotiate contracts with providers without government interference. With the changes that were secured in the current version to protect hospitals, the MHA is neutral on the package.

In the Senate, Sens. Lana Theis (R-Brighton) and Curtis Hertel (D-East Lansing) have introduced bills that mirror the language in the House’s surprise billing package. Theis, who chairs the Senate Committee on Insurance and Banking, is also holding hearings on the issue. Those hearings are expected to continue; however, legislative action is likely to be focused on the House package. Members with questions should contact Adam Carlson at the MHA.


  • Surprise Billing Legislation Approved by House Health Policy Committee

Tags: HB 4459, HB 4460, surprise billing, Adam Carlson, HB 4990, HB 4991

Posted in: Issues in Healthcare, Member News

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