State

Ever received a 'surprise' bill from a doctor? A Georgia lawmaker wants that to stop.

State Rep. Richard Smith says he recently spoke to State Revenue Commissioner Lynne Riley about the possibility of rolling back Muscogee County tax assessments.
State Rep. Richard Smith says he recently spoke to State Revenue Commissioner Lynne Riley about the possibility of rolling back Muscogee County tax assessments. Ledger-Enquirer file photo

A Georgia state House member says he wants to put an end to so-called "surprise" medical bills — charges of hundreds or thousands of dollars that arrive after someone visits an out-of-network doctor without meaning to.

"You go to a hospital and have a scheduled procedure and you think your insurance covers everything and then all of the sudden you get a bill in the mail for $500, $5,000, $10,000," said state House Insurance Committee Chairman Richard Smith, R-Columbus. "There was a guy in Columbus who got a bill for $15,000. This should not be happening. The cost of health care is killing us," he said.

Smith's new House Bill 678 would require that patients scheduling a procedure receive a list ahead of time showing exactly which doctors they'll see, what insurance would cover, and what the balance charge would be.

With that list, a patient could decide to shop around if there are more providers. Or if not, at least the bill would not be a surprise.

In a typical surprise billing case, is a person schedules a procedure at a hospital that's in their insurance network, but along the line they get care from someone who’s not in their network, like an anesthesiologist, for example. Across the country, states are looking at how to remove patients from the tug-of-war between what doctors charge and insurance pays for out-of-network care.

Last year under the Gold Dome in Atlanta, hearing rooms filled up for debates on proposals to cut the patient pain of surprise bills, including ideas for setting how much doctors can charge for out-of-network care, and requiring that doctors who practice at a hospital join all of that hospital's insurance networks.

All those proposals are still alive and debatable for this year's session. But they're also contentious, as medical and insurance lobbies look out for their members' interests.

Smith's new bill is shorter than some of the others that he himself has written or signed and thus it might be easier to get to the governor's desk.

"Health care, as far as cost is concerned, is kind of like a black hole. You don’t have any clue about what’s happening until all of the sudden you get a surprise bill in the mail," Smith said.

The Medical Association of Georgia did not have any immediate comment on the new bill.

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