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HB 4011 would prohibit a healthcare provider from reporting to a consumer reporting agency an unpaid debt for nonemergency medical care unless the provider discloses the cost of the medical care to the patient in advance of providing the care and obtains a signature on the disclosure form consenting to the charges. If those conditions are met the provider would have to wait at least 180 days after the date the consumer receives the medical bill before being able to report the debt to the consumer reporting agency. A consumer reporting agency would be prohibited from reporting information regarding this debt unless the above mentioned conditions have been met.
The executive commissioner of the Health and Human Services Commission would be required to prescribe the form and content of the disclosure required, and the Department of State Health Services shall publish the disclosure form on the department's website.
This is an attempt to address the growing problem of balance billing in which certain healthcare providers bill patients incredible amounts of money for services without first disclosing what the charges will be and securing the patient's agreement to pay the charges.
Balance billing typically occurs when a physician bills a patient for medical expenses that the patient’s insurance plan does not cover. This issue is especially prevalent in, though not exclusive to, emergency room visits. Moreover, it is very difficult for a patient to find out how much a service would cost for an out-of-network provider. Unfortunately, this means a patient is charged additional medical expenses because, unbeknownst to the patient, a physician or service is not covered under his or her insurance plan. A key factor to remember in all of this is that the patient was not presented with the charge in advance and therefore never agreed to it.
Overregulation of the healthcare and health insurance industries has caused this issue to come into existence. If the free market were allowed to operate in these industries, this arbitrary billing practice would result in medical care facilities or physicians losing business rather than getting away with using deceptive practices to obfuscate the true cost of services and later using threats of negative credit reporting to secure payment of charges.
Certainly by accepting medical service a patient who has been balance billed has implicitly agreed to pay for those services. This legislation protects the property rights of patients by giving them a little bit of room to negotiate for a reduction in the charge to a reasonable amount. If they are presented with a disclosure of charges and sign the receipt in advance of service as this bill proposes they will be responsible for the full amount of service. If they are not given disclosure and do not agree to a specific amount they would still be responsible to pay but the provider will have an incentive to work out an agreeable payment.
With all of this background in mind we support this bill as an enhancement of the property rights of patients to not have to pay the full amount of charges they were not presented with until after the service was rendered in the nonemergency circumstances described in the bill.