Virginia fails to pass Balance Billing law
Sep 2, 2008
I found an interesting article on TipHero about balance billing. TipHero describes it as:
[when] a hospital or medical provider bills the patient for the portion of a bill the patient’s insurance company doesn’t pay.
My ears perked up. I've agonized over hospital bills before trying to figure out why I was paying so much.
TipHero then noted that balance billing is illegal in many states; I immediately wanted to know if it was legal or illegal in Virginia. Apparently it's legal as of now, but there is a bill lagging in the Virginia House. According to Richmond Sunlight, the bill was left in committee in February. According to this page, HB 318 would:
Prohibits a physician who does not participate in a health insurance carrier's provider panel from balance billing an enrollee for the difference between his charges and the amount paid by the carrier for covered services performed at a participating hospital, unless the hospitalized enrollee has consented in writing, prior to receiving the services, to the use of the nonparticipating physician.
As far as I can tell, if you travel by ambulance to the hospital, rack up $6,000 in bills, but your insurance only covers $3,000, you cannot be billed for the remainder per the law; additionally, it appears that this only applies to emergency services. I assume because in an emergency situation, no one cares to take the time to look up "preferred providers" as listed by your insurer.
This scenario reminds me of a scene in Michael Moore's Sicko where the girl describes an emergency room visit that was denied coverage by her insurer because it wasn't "pre-authorized."
Perhaps when the legislature is back in session, it's worth a note to your representative to urge them to push this bill on through.
Labels: health insurance, politics
posted by Amanda @ 11:05 AM,