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'Balance Billing' Proposal Clears House Panel

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
Florida House
The Florida Channel
"The consumer has to be protected,'' state Insurance & Banking Chairman John Wood, R-Winter Haven.

In an issue watched closely by doctors, hospitals and insurers, a House panel Tuesday approved a proposal aimed at protecting patients from surprise charges when they need emergency care.

The bill (HB 221), approved by the House Insurance & Banking Subcommittee, deals with an issue known as "balance billing." That can occur, for example, when patients need emergency care and are treated by doctors who are not part of the networks of the patients' insurers. In such cases, patients can get billed for differences between what their insurers pay and additional amounts that are charged.

The bill would make insurers responsible for paying for emergency services and would include an arbitration process to resolve differences between insurers and health-care providers.

The Florida Association of Health Plans, which represents insurers, supports the proposal.

But physician and hospital groups raised concerns about the bill, in part because of a provision that says insurers could pay a "reasonable reimbursement" for care.

Steve Ecenia, an attorney for the HCA hospital chain, said the problem is determining what a "reasonable" charge would be. Ecenia and some lawmakers said a solution might be to make clear patients aren't responsible for extra charges and then let insurers and providers resolve billing disputes on their own.

"The consumer has to be protected,'' Insurance & Banking Chairman John Wood, R-Winter Haven, said. "There's no dispute about that."