Consumer Bill Takes Heat From Doctors

Mar 31, 2015

A bill designed to protect patients from unexpected charges for emergency treatment – so-called “balance billing” -- passed the powerful House Appropriations Committee on Tuesday.

But its future remains uncertain amid opposition from the Florida Medical Association and Florida Hospital Association.

Health-care providers who aren’t in a contract with an insurer say they shouldn’t be bound by what that insurer wants to pay. Insurers say they shouldn’t be forced to pay more than is reasonable.

Rep. Carlos Trujillo, R-Miami
Credit Florida House of Representatives

Millions of Floridians are at risk for balance billing, mostly members of preferred provider organizations, called PPOs. Such plans have contracts with health-care providers, but PPO members can opt to go outside the network by paying extra.

Under Florida law, only patients in HMOs are currently protected if they are treated out-of-network in a medical emergency.

“We’re trying to do the same thing for consumers in PPOs,” said the bill sponsor, Rep. Carlos Trujillo.

Members of the House Appropriations Committee said they agree with the intent of the bill, to protect insured patients from being saddled with debt. But they asked Trujillo to work out a compromise that will avoid harm to doctors, hospitals and ambulance services.

“We want to make sure our health-care providers don’t get the short end of the stick,” said Rep. Alan B. Williams, D-Tallahassee.

Trujillo, R-Miami Dade, said he will keep working on the bill, “Health Insurance for Emergency Services,” CS/HB 681. He said he has already met for many hours with health care providers trying to find language that will satisfy them while protecting patients.

“Unfortunately, health care is much more complex than it seems,” Trujillo said.

Lawmakers are clearly getting heat from physicians and municipal ambulance services that engage in balance-billing, and from hospitals that are nervous at the prospect of having contracts disrupted.

Earlier Tuesday, the Senate Banking and Insurance Committee placed a temporary hold on the companion bill, SB 516, at the request of its sponsor, Sen. Aaron Bean, R-Jacksonville.

Despite his power as chairman of the Senate Health Policy Committee, Bean still appeared to need a time-out to douse fires the health-care providers were setting.

Sen. Bill Montford, D-Tallahassee, said, “My own cardiologist called me about it.” 

Carol Gentry is a reporter with WUSF in Tampa. Health News Florida receives support from the Corporation for Public Broadcasting.