Senate bill to address surprise medical billing now in House

By Jim Hannah
Legislative Research Commission

FRANKFORT, Ky. – Legislation to offer patients some protection from surprise medical bills passed the state Senate Friday.

“There are many factors that contribute to surprise billing,” said Sen. Ralph Alvarado, R-Winchester. “Some will place the blame on insurance companies. Some will place the blame on providers. It all depends on whom you ask. But while we are trying to figure out who to blame, patients are stuck in the middle of the problem – often with large medical bills.”

Alvarado’s Senate Bill 150 seeks to stop the practice by requiring insurers to cover surprise billing, sometimes called balanced billing. It happens when a patient receives medical care – often unwittingly – outside of their insurer’s network. Subsequently, the doctor or hospital bills the patient for the amount insurance didn’t cover.

Alvarado characterized SB 150 as a consumer protection bill. He said surprise billing was a dubious exercise of cost shifting from insurers to patients.

A second provision of SB 150 would require the state insurance commissioner to establish a database of billed health-care service charges. A final provision would provide a dispute resolution program for medical insurers and providers to work out their differences over these out-of-network charges.

Sen. Rick Girdler, R-Somerset, spoke against the bill. He cited a fiscal impact estimate that SB 150 would increase individual premiums for health benefit plans by up to $9 per month.

Sen. Tom Buford, R-Nicholasville, said he voted for the bill because the He noted the self-funded Kentucky Employees’ Health Plan already covers surprise billing for its nearly 265,000 members.

“If we are going to enjoy that benefit, the citizens of Kentucky should share the same,” he said.

Sen. Wil Schroder, R-Wilder, who voted no, said what is needed more is broader reform to empower health-care consumers through such measures as transparent pricing of procedures and drugs.

“Today I filed Senate Bill 265 that I believe offers a better solution in the context mentioned,” Schroder said. The bill has been assigned to the Senate Banking and Insurance committee.

Alvarado said SB 150 wasn’t a hastily drafted bill, but the result of three years of investigation.

“I wish to remind the members of the Senate that a successful bill for surprise billing should only make one group happy – and that is the patients we are trying to protect,” he said. “If other stakeholders are a bit uncomfortable, then we have a good compromise on this issue.”

SB 150 went to the House on a vote of 30-3. Sen. John Schickel, R-Union, cast the only other “no” vote.