Georgia Watch supports surprise billing legislation to protect Georgia consumers from unexpected out-of-network medical costs in an emergency or during a planned procedure.
A surprise medical bill can occur when an insured consumer inadvertently encounters out-of-network providers at an in-network facility during the course of their care. The consumer is then responsible for the excess medical costs – which can amount to thousands of dollars. Surprise bills often occur in a hospital or ambulatory care facility where anesthesiologists, surgical assistants, emergency room or other specialty care providers are frequently contracted. These providers do not necessarily participate in all of the same insurance plan networks as the facility in which they work. Consumers may not receive advance notice that they could encounter an out-of-network provider or an estimate of what the cost of that care might be. Consumers could receive surprise medical bills in the following scenarios:
- When they seek care at an emergency room at an in-network hospital and are unaware that some of the contracted providers are outside of their insurance plan network.
- When they have a planned procedure at an in-network hospital and certain hospital-based providers involved in the procedure, such as anesthesiologists or surgical assistants, are outside of their insurance plan network.
- When lab work or ultrasound tests are sent to out-of-network lab companies or radiologists.
- When provider directories are out-of-date, and consumers are ill-informed about which providers are actually in their network.
States including New York, Connecticut, Florida, Texas and California have passed laws containing surprise billing protections for consumers, and a bill was recently considered in the U.S. Congress (HR 3770).
If you have a surprise billing story, please share that with us here.
Current Georgia Legislation: Two pieces of legislation have been introduced to address surprise billing.
- Introduced by Rep. Richard Smith (R-134), House Bill 84 would increase transparency related to possible surprise medical bills by setting disclosure requirements for health care providers, insurers, and hospitals.
- Senate Bill 56, introduced by Georgia Watch’s 2018 Lifetime Achievement Consumer Champion Award recipient, Senator Chuck Hufstetler (R-52), would address surprise out-of-network billing by disallowing surprise billing in emergency situations under insurance plans issued after July 1, 2019.
Georgia Watch followed these two bills closely, hoping consensus would reached between the two chambers this year so that patients could be taken out of the middle of this problem. Ultimately, neither bill succeeded. We are grateful to Chairman Richard Smith and Chairman Hufstetler for their work on this important issue and hope to find a resolution for consumers in the next legislative session.
Past Georgia Legislation: Senator Chuck Hufstetler (R-Rome) filed Senate Bill 359 on January 26, 2018. Georgia Watch supported SB 359 because it would protect consumers from out-of-network bills in emergencies. Senate Bill 359 unanimously passed the Senate on February 28, 2018. The language of Senate Bill 359 was amended into House Bill 314, but this legislation stalled in the House of Representatives. As a result, surprise billing legislation did not pass in Georgia during the 2017-2018 Legislative Session. Previously, Senator Renee Unterman (R-Buford) introduced two pieces of legislation to address surprise medical bills during the 2016 Legislative Session, and she pre-filed Senate Bill 8 in advance of the 2017-2018 Legislative Session. Representative Richard Smith (R-Columbus) filed House Bill 71 in January 2017. SB 8 passed the full Senate on February 24, 2017 but did not receive a vote from the full House before the end of the 2017 Legislative Session. A House study committee chaired by Representative Smith convened throughout 2017 to examine the issue of unexpected out-of-network medical bills, and Georgia Watch provided testimony. Representative Richard Smith filed House Bill 678 at the start of the 2018 Session. HB 678 is a transparency focused bill, and you can see news coverage about the legislation here. HB 678 passed the House of Representatives on Monday, February 12, 2018 but did not move forward during the 2018 Legislative Session.