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10/01/2015

Insurance Commissioner Holds Public Hearing on Surprise Balance Billing, Hears from Consumers, Industry, and other Stakeholders

Harrisburg, PA - Insurance Commissioner Teresa Miller today held a public hearing on the issue of surprise balance billing, an issue where a consumer -- after receiving a service from a health care provider that is in-network for the consumer’s health insurance-- receives a bill for a portion of the care. In many cases, consumers exhausted all reasonable options to ensure the doctors they would see were in-network but still encountered an out-of-network service provider or facility at some point during their care.

“My goal, in addition to gathering information on the issue of surprise balance billing, is to get ideas on how to deal with this problem and draw input from everyone involved,” said Commissioner Miller during her opening statement at the State Museum in Harrisburg.

Commissioner Miller and other representatives from the Pennsylvania Insurance Department heard testimony from health insurance industry representatives, health care providers and facilities, affected consumers, Senator Judy Schwank, and other advocates interested in finding a solution to this issue.

Throughout the hearing, testimony focused on a need to remove consumers, many of whom took the time and effort to fully research their options to make sure the doctors and facilities are in-network, from the middle of billing disputes.

Commissioner Miller heard stories of and testimony from various consumers who have been victims of surprise balance billing. Many consumers reported having received unexpected charges for a few hundred dollars, but one consumer from Dingmans Ferry, Pa. received a bill for more than $30,000 after his local hospital transferred him to another facility in New York. This bill was eventually resolved due to a New York law that removes consumers from the balance bill settlement process.

“We must work to find a way to protect consumers from these bills,” said Commissioner Miller. “When someone undergoes a major medical procedure, they need to focus on their recovery, not an unexpected fee.”

Consumers and consumer advocates at the hearing even expressed apprehension towards seeking additional or future medical intervention for fear of receiving unexpected bills. One consumer in particular said that she would no longer undergo mammograms, despite being at a high-risk for breast cancer, because her care provider contracted with an out-of-network doctor to read the test.

At the end of the hearing, which featured testimony from approximately 20 people, Commissioner Miller was optimistic about the ideas presented and the possibility of working to end this issue.

“I want to thank everyone who participated in today’s hearing,” concluded Commissioner Miller. “We were not only able to get a sense of the balance billing issue in Pennsylvania, but we also now have new ideas about how we can move towards solving this problem. We all need to work together to be a part of the solution.”

Full video of the hearing and written testimony from interested parties will be available at www.insurance.pa.gov. If you believe you have been balance billed, Commissioner Miller encourages you to contact the Insurance Department’s Bureau of Consumer Services online to file a complaint or by phone at 1-877-881-6388.

MEDIA CONTACT: Ron Ruman - 717-787-3289

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