NJ measure to eliminate ‘surprising’ costs from patients’ bills stymied

A legislative proposal designed to protect patients from “surprise” medical bills continues to hit snags in New Jersey.

 

Consumer advocate groups are pushing the Senate Commerce Committee to hold a hearing on the proposal — as written. The New Jersey Hospital Association and other groups are saying the bill needs to be revised.

Charles Bell, program director for the Consumers Union — the policy arm of Consumer Reports — said surprise bills are common.

“It happens quite often that consumers are seen by doctors that are not in their health plan, that they did not specifically authorize, and the consumer is stuck with a balanced bill,” Bell said.

There’s a push to demand that hospitals notify patients when a higher-cost health provider will be treating them.

Despite being a nurse who knows the health care system, Anne Bagchi from East Brunswick, New Jersey, was caught off guard when her daughter moved from inpatient to outpatient care. Suddenly, the medical bills more than doubled.

“If someone lets you know beforehand, then you can make a more informed decision,” Bagchi said.

The New Jersey Hospital Association said patients should be better protected, but it has concerns about the current proposal.

“We think hospitals need to do a better job at the time of scheduling and let the patient know: Listen, some providers are not employed by the hospital and may be out of your network,” said Neil Eicher who leads government relations and policy at the association.

He said the legislation would limit what hospitals can charge in emergency situations, a provision that he said would place medical centers at a disadvantage when they negotiate rates with insurance companies.

Bell said another provision of the legislation was written to make sure patients can concentrate on recuperating from treatment, instead of haggling with the hospital over costly bills.

“The bill also creates an independent dispute resolution process so that a consumer can be removed from the middle of a dispute,” Bell said. “The providers and insurance company would negotiate directly with each other.”