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10/19/2016

Insurance Commissioner Testifies Before Pennsylvania Senate Banking and Insurance Committee on Surprise Balance Billing

​​Harrisburg, PA - Insurance Commissioner Teresa Miller today offered testimony to the Pennsylvania State Senate Banking and Insurance Committee on the issue of surprise balance billing in Pennsylvania and steps her department has taken to address the problem. The hearing was held Wednesday morning on Senate Bill 1158 (SB 1158), sponsored by Senator Judy Schwank (D-Berks), which provides a proposed solution to surprise balance billing.

Surprise balance billing occurs when a consumer encounters an out-of-network facility or provider at some point during their care. This can occur even if a consumer makes an effort to ensure that providers and facilities through which they receive care are in-network.

“We have heard from consumers who had done their research and understood the providers and facilities they received care from were all in-network, only to find that despite these efforts, they received unexpected and upsetting bills,” said Commissioner Miller. “Given Governor Wolf’s and my priority of consumer protection, I believe this is an issue worth exploring, and my department has been doing so.”

The Insurance Department has received numerous complaints about this practice over the past few years. Last October, the Insurance Department held a public informational hearing to assess stakeholder interest and better understand varying perspectives on the issue. The hearing allowed the department to hear from consumers, insurance companies, hospitals, private physician practices, and other impacted stakeholders in a transparent environment.

Using the input gathered at this hearing, as well as actions taken by other states to address the issue, the department has been working on developing a recommended solution that protects consumers from surprise balance bills based on recommendations presented by stakeholders and actions taken by other states on the matter. The department circulated a draft proposal for public comment earlier this year and continues to work on refining the specifics as a result of stakeholder input and recommendations. 

“SB 1158, though currently not identical to the proposal circulated by the department, works toward the same goal of taking consumers out of these situations and protecting them from surprise balance bills,” said Commissioner Miller. “Sen. Schwank and the department share a similar goal of creating a process for the providers and the insurer to negotiate fair reimbursement for these services.”

Commissioner Miller thanked Majority Chair Senator Don White, Minority Chair Senator Sean Wiley, Senator Judy Schwank, who introduced SB 1158, and the other committee members for the opportunity to speak at the hearing.

“The Insurance Department looks forward to continuing discussions on this issue with both stakeholders and the General Assembly,” said Commissioner Miller.

For more information on the Insurance Department’s balance billing proposal, click here. If you have received a surprise balance bill and are in need of assistance, you may contact the department’s consumer services bureau at 1-877-881-6388 or online at www.insurance.pa.gov

MEDIA CONTACT: Ali Fogarty - 717-787-3289

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