Delaware legislators introduce legislation to stop surprise billing
Calling this a “good day for Delaware health care consumers,” Delaware Healthcare Association President and CEO Wayne Smith lauded Rep. David Bentz, D-Christiana, Senate President Pro Tempore David McBride, D-New Castle, Sen. Bryan Townsend, D-Newark, Sen. Nicole Poore, D-New Castle, and a bipartisan group of sponsors and cosponsors who introduced House Bill 286, legislation that would protect patients from “surprise” medical bills.
The bill builds on existing Delaware law that protects patients from surprise bills arising from emergency department access of services and expands these protections to services received from non-network providers at in-network facilities.
“When you or a loved one go to the doctor for a medical issue, the last thing you should be thinking about is how much is the cost, but that’s the sad reality of our healthcare system,” said Bentz. “Surprise bills have the power to derail a person’s life and finances, and we should do what we can to expand protections against this practice. This legislation builds on an existing process that already works to protect consumers and identifies an issue that causes much anxiety and stress. No one should go bankrupt because they became sick or injured, and I’m encouraged by the steps we take with this measure.”
“No one experiencing a serious medical issue should fear being hit with a huge bill because someone didn’t tell them a doctor or a lab was out of network,” said McBride, the bill’s chief sponsor in the Senate. “That’s literally adding insult to injury, and it’s time we closed this loophole in our healthcare policy.”
“Delawareans should be able to focus on getting healthcare and getting well, without having to worry about surprise medical bills,” said Townsend, chair of the Senate Health & Social Services Committee. “We should pass this and other legislation that gives Delawareans more of the peace-of-mind they deserve.”
“When your loved one is sick and in need of medical attention, the last thing you’re thinking about is the fine print of your insurance coverage,” said Poore. “The residents of our state deserve a cohesive health care system that ensures patients are well cared for, not the shell game of surprise billing."
“No patient should be stuck with a surprise medical bill,” said Smith. “Delaware hospitals fully support HB 286. This bill ensures no patient would ever get a surprise bill from a Delaware in-network facility. We thank Representative Bentz, Senators McBride, Townsend, Poore, and the bipartisan group of co-sponsors for attempting to make Delaware a leader in protecting patients from surprise medical bills.”
Additional Prime Sponsors of the bill include Sherry Dorsey-Walker, D-Wilmington; Ray Seigfried, D-Brandywine Hundred; and Steven Smyk, R-Milton.
“Surprise medical billing is systemic of our fragmented health care system,” said Seigfried. “It should not be incumbent on a patient in a vulnerable position to differentiate between their in-network facility and out-of-network provider. This bill provides some relief to this troublesome event.”
Additional cosponsors include Sens. Bruce Ennis, Hansen, Trey Paradee, Brian Pettyjohn and David Sokola, and Reps. Paul Baumbach, Ruth Briggs King, William Carson, Nnamdi Chukwuocha, Debra Heffernan, Earl Jaques, John Kowalko, Edward Osienski, Jeffrey Speiglman and Kimberly Williams.
“While we can’t prevent illness or injury, we can make sure that Delawareans do not fall victim to surprise medical bills,” said Pettyjohn. “I am pleased to join my colleagues in cosponsoring this important bill.”
A surprise bill typically refers to situations where a patient either receives emergency department services from non-network providers or when a patient receives non-emergency care from an out-of-network provider at an in-network facility without this being disclosed in advance. Delaware already protects patients from surprise bills regarding emergency department services, but HB 286 provides more comprehensive patient protection by expanding those to cover inadvertent out-of-network service provision at health care facilities in non-emergency cases.
Under the legislation, surprise bills would no longer go to patients but would be settled between providers and health insurers through negotiation. If agreement could not be reached, rules utilized by the insurance commissioner provide for alternative dispute resolution. Balance billing the insured in these situations is not permitted.