State legislation introduced to stop surprise medical billing

January 30, 2020

Calling it a good day for Delaware healthcare consumers, Delaware Healthcare Association President and CEO Wayne Smith recently lauded a bipartisan group of sponsors and cosponsors who have introduced House Bill 286, legislation that would protect patients from “surprise” medical bills.

The bill builds on existing Delaware law that protects patients from surprise bills arising from emergency department access of services and expands these protections to services received from non-network providers at in-network facilities.

“No one experiencing a serious medical issue should fear being hit with a huge bill because someone didn’t tell them a doctor or a lab was out of network,” said Senate President Pro Tempore David McBride, D-New Castle, the bill’s chief sponsor in the Senate. “That’s literally adding insult to injury, and it’s time we closed this loophole in our healthcare policy.”

Cape Region co-sponsors of the bill include Rep. Steven Smyk, R-Milton; Rep. Ruth Briggs King, R-Georgetown; and Sen. Brian Pettyjohn, R-Georgetown. 

“While we can’t prevent illness or injury, we can make sure that Delawareans do not fall victim to surprise medical bills,” said Pettyjohn. “I am pleased to join my colleagues in co-sponsoring this important bill.”

A surprise bill typically refers to situations when a patient either receives emergency department services from non-network providers or receives non-emergency care from an out-of-network provider at an in-network facility without this being disclosed in advance. Delaware already protects patients from surprise bills regarding emergency department services, but HB 286 provides more comprehensive patient protection by expanding those to cover inadvertent out-of-network service provision at healthcare facilities in non-emergency cases.

Under the legislation, surprise bills would no longer go to patients but would be settled between providers and health insurers through negotiation. If agreement could not be reached, rules utilized by the insurance commissioner provide for alternative dispute resolution. Balance billing the insured in these situations is not permitted.