Bills to End Surprise Medical Billing Advance in Oklahoma

March 16, 2020

Two pieces of legislation that would end surprise medical billing for Oklahoma residents have passed the state’s House of Representatives.

House Bill 3388, authored by Reps. Chris Sneed (R-Fort Gibson) and Tammy Townley (R-Ardmore), and House Bill 3483, authored by Marcus McEntire (R-Duncan), both passed the House of Representatives with votes of 92-3 and 95-0 respectively.

Sneed, Townley and McEntire have agreed to work together to ensure one piece of legislation gets through the state Senate and onto the governor to be signed into law in order to protect Oklahomans.

A surprise medical bill often comes when an insured person goes to an in-network facility to get a covered procedure done, but an out-of-network provider actually provides services resulting in a bill not covered by the insurance company and hence a surprise to the insured.

A balanced bill, on the other hand, is one which an insurance company says beforehand they are not going to pay the amount charged by the provider. This gives the insured the option to pursue treatment or not.

Both bills would prohibit health providers from charging a patient the difference between their fee and what an enrollee’s health insurance pays, and they make provisions for emergency services.

HB 3388 directs the state insurance commissioner to select a nonprofit organization to maintain a benchmarking database containing information on percentiles of billed charges from out-of-network providers and rates paid to in-network providers, in order to determine the usual, customary, and reasonable rate insurance carriers would be required to pay.

HB 3388 also directs that if an insured patient receives emergency services from an out-of-network provider, the patient will no longer be responsible for any amount greater than what they would pay in-network. The bill would require arbitration in cases of disputed payment.

HB 3483 would require the state department of health to require health facilities to post on their websites information related to their contracts with insurers for services and a disclosure statement about patients’ potential risk of being balance billed. The measure would allow out-of-network providers and health insurers to request mediation to settle disputed claims.

Source: Oklahoma House of Representatives

Was this article valuable?

Here are more articles you may enjoy.