Surprise Medical Bills Get Attention

Sep 6, 2019

Insurance companies and healthcare providers are engaged in a pitched lobbying effort in Washington and Richmond on surprise billing.

Imagine you are out in rural Virginia and you have a medical emergency. You need to be air lifted to a hospital miles away. Eventually you get a bill, an astronomical bill with an eye-popping number you can’t afford.

Jill Hanken at the Virginia Poverty Law Center says patients need lawmakers to step in and provide protection.  “When a consumer has insurance and they have an emergency and they go to an in-network provider they should never get a balance bill.”

But when insurance companies and health-care providers can’t come to an agreement, patients get stuck holding the bill. One potential solution on the table in Washington and Richmond would force some kind of arbitration. Another would use a regional average to come up with a bill.

Clark Barrineau at the Medical Society of Virginia says one approach he’s concerned about would be benchmarking a dollar amount to an arbitrary number that would be the same in Bath County as it would be in Arlington. “Rural providers already operate on such thin margins, it would eventually force providers to make some hard business decisions, and nobody wants that to happen because those are the parts of the commonwealth who need care the most.”

This fall, the U.S. Senate is expected to debate a bill that would offer benchmarking as a potential solution for surprise billing. But Barrineau says that could hit rural communities in Virginia hardest.

This report, provided by Virginia Public Radio, was made possible with support from the Virginia Education Association.