The Michigan Senate Insurance and Banking Committee approved legislation Jan. 22 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 Senate Bills (SBs) 0570, 0571, 0572 and 0573, and was introduced by Sens. Lana Theis (R-Brighton) and Curtis Hertel Jr. (D-East Lansing), with substitutes introduced by Sen. Ken Horn (R-Frankenmuth) for SBs 0570 and 0572. The Senate bills are similar to the House bills that are in the House Ways & Means Committee after a vote in November 2019.
For emergency situations or in cases where a patient does not have the opportunity to choose an in-network provider, SB 570 would set insurance reimbursement at the greater of 150% of Medicare or the average in-network accepted rate for the patient’s health plan. SB 572 would require healthcare providers to obtain the patient’s written consent 21 days before proceeding with nonemergency services that would result in an out-of-network medical bill or at the time of care scheduling, whichever is earlier. SBs 571 and 573 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, the Senate bills will ensure Michigan hospitals can continue to negotiate contracts with providers without government interference. With the changes that were secured to protect hospitals, the MHA is neutral on the package. Members with questions should contact Adam Carlson at the MHA.