Medical Billing Legislation Brings Hope, Disappointment For Consumers In CO & MS

By Consumers For Quality Care, on February 13, 2019

The Colorado State Legislature recently introduced legislation to protect consumers from surprise medical bills, FOX reports. Surprise billing, a practice where consumers are charged for receiving care from out-of-network practitioners at in-network facilities, is increasingly common for consumers. Recent CQC research found that 74 percent of consumers are frustrated by unexpected hospital bills and fees.

The law would limit how much consumers could be charged in a surprise medical bill. Under the legislation, Coloradans insured by plans regulated by the Colorado Division of Insurance would have bills capped at 125 percent of the Medicare reimbursement rate, the average in-network rate for the area, or the average in-network rate according to the “All Payer Claims Database.”

Despite previous defeats, Colorado legislators seem confident in the new bill.

“It’s a loophole in our system that some people are making a lot of money on,” State Senator Brittany Pettersen (D – Lakewood) said.

While consumers in Colorado see signs of progress limiting surprise medical bills, consumers in Mississippi are less optimistic after similar legislation recently failed to pass in the state.

According to Mississippi Today, the legislation would have required enforcing existing laws on balance billing and established binding arbitration between consumers and providers.

An overwhelming majority of Mississippians support anti-balance billing measures, according to a Mason-Dixon poll conducted on behalf of Mississippi Health Advocacy Program. Of the 625 Mississippi voters surveyed in January, 40 percent said they or a family member had received a surprise medical bill in the past. Eight[y]-five percent said they support laws to protect patients against these bills by requiring providers and insurers to settle billing disputes themselves.