Score One for the Little Guy

31 Jul Score One for the Little Guy

FL HB 221 passed at the final moments of the legislative session, and it is a win for anyone who has ever received a surprise Out of Network bill for services performed at an in-network hospital.  Current law allowed a non-network provider to pass along a balance bill to PPO and EPO members even though they were delivering services at a facility in the insurance network.

In recent years this has escalated, with providers and insurance companies playing a game of one-ups-manship, leaving the policyholder to mop up (really- pay up) the difference.

HB 221 ends this.  For services provided at in-network facilities, insurance companies are required to charge policyholders the same for in network and out of network providers in in-network facilities.  The insurance company and the providers then work out a feasible payment amount behind the scenes.

This bill fixes a loophole that sorely needed to be fixed and moves the meter a little more towards a transparent medical marketplace where everyone can see the actual costs for procedures.

Attached is the Summary of the Bill.

These provisions go into effect July 1, 2016.

Let us know if you have any other questions.


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