Surprise medical billing protection law in Georgia takes effect Friday
(The Center Square) – A law that stops Georgians from receiving unexpected medical bills becomes effective Friday.
The Surprise Billing Consumer Protection Act, House Bill 888, stops patients from being charged for out-of-network health care services.
The legislation received bipartisan approval from the General Assembly in June and has been applauded by many in the medical community. It was signed into law by Gov. Brian Kemp in July.
Kemp called the legislation “a historic step forward for Georgia when it comes to health care.”
Georgia is among 30 states that have enacted surprise billing legislation, according to data from the Commonwealth Fund.
Surprise bills often are a result of emergency room or urgent care visits when patients go to facilities that are covered by their insurance plans but are treated by a physician or medical professional who is not within the insurer’s network.
The insurance company could opt out of paying for the services, and patients could end up being billed by the provider, oftentimes weeks later.
An average of 13% of emergency room visits in Georgia in 2017 resulted in at least one out-of-network charge, Kaiser Foundation researchers found.
The Surprise Billing Consumer Protection Act removes patients from the process and allows the medical provider to bill the insurance company directly. Insurance companies now have the option to negotiate the price through an arbitrator, a qualified third-party medical professional who will review the claim.
According to the Taxpayers Protection Alliance, blocking surprise bills also can reduce government spending on health care, especially on public-funded plans.
After examining data from a commercial insurance company, Yale University researchers estimated resolving the issue could have decreased health spending by $40 billion for the tens of millions of Americans the company covered.
Senate Bill 28 also secures pricing protection from Georgians and goes into effect Friday. It also was signed into law by Kemp in July after bipartisan support from the Georgia Legislature. It blocks certain insurers from charging excessive copayments. Copayments must serve as “an incentive rather than a barrier to access appropriate care” and “must not unfairly deny necessary health care services,” according to the law.
