It’s rare these days that Democrats and Republicans can come together to agree on anything, let alone have one side, sort of, praise the other.
However, recently, both the Ohio legislature and the federal government have had laws go into effect that help keep people from receiving surprise medical bills.
The Ohio law went into effect earlier this week and is designed to shield patients from receiving and paying surprise medical bills after certain unanticipated treatments.
These bills can easily range from hundreds of dollars to thousands.
I know of at least twice such a situation has happened to my family in the last few years.
Several years ago my wife had to have hip surgery, and we went through all the pre-approval process.
The surgery was successful and well done, and months later when the bills started rolling in we found her insurance did not cover the anesthesiologist who was brought in on the surgery.
The anesthesiologist was out of network, but of course that had not been revealed, somehow, during the pre-approval process and we did not think to ask him if he was in-network as my wife was being rolled into surgery.
A couple of years ago, I had to have blood tests run and was told to simply go to the hospital lab down the hall from my general practitioner, who was in-network for my insurance, and have it done.
So I did. And was rewarded a few months later with a statement I was on the hook for about $600 for the lab because it was out of network from my insurance.
I was not given a choice on where that blood specimen would be sent to be tested, nor was I informed ahead of time that the lab chosen is out of network of my insurance.
This Ohio bill, and the federal one also that went into effect Jan. 1, will presumably keep such surprise billings from happening.
“I appreciate the work of the Ohio Legislature and representatives of the medical and insurance communities for coming together on this issue and for doing what is right for Ohioans,” said Ohio Gov. Mike DeWine this week.
U.S. Sen. Sherrod Brown, D-Ohio, pushed for such legislation on the federal level and said while he’s glad the Ohio legislature passed such a measure, the federal bill offers further protection for Ohioans.
“Think about it this way, if an Ohioan is in another state, they are now protected and they would not have been under (just) the Ohio law,” Brown said.
“We know how much of a problem these out-of-control surprise bills have been and health care remains one of the most stressful costs families face,” Brown added.
“A patient can do everything right but still find themselves waking up from surgery, expecting to pay their standard co-pay, only to find out their anesthesiologist was out-of-network and they owe several thousand dollars in surprise bills,” he said.
Boy, does that sound familiar.
Brown also said a recent report released by the U.S. Department of Health and Human Services (HHS) found that approximately 1 in every 5 Americans has received a surprise bill following an elective surgery or after giving birth at an in-network facility.
While both bills are meant to eliminate the kind of surprise billings patients encounter, Brown said insurance companies likely will still look for loopholes.
Both the Ohio and federal law have contingencies in place in case someone still receives a surprise bill.
In the Buckeye State, the Ohio Department of Insurance is responsible for administering and enforcing many of the law’s provisions.
Judith L. French, director of that department, said they will be “aggressive” in protecting consumers. Staff there are expected to conduct a consumer education campaign letting people know their rights under the law.
Those with complaints in Ohio can call 1-800-686-1526.
On the federal level, U.S. residents can visit CMS.gov/nosurprises or call 1-800-985-3059 between 8 a.m. and 8 p-m any day of the week to ask questions or report a potential violation of this law.
This was a problem that needed solving, and it’s good to see both sides come together to do it, both at the state and national level.
Now, if we could only have some more of that, please.