ATLANTA – The Georgia House of Representatives is putting forth its own version of “surprise billing” legislation.
A committee the House formed last year to explore ways to increase access to quality health care passed a bill Monday to set up a rating system Georgians could use to determine which physician specialty groups in their insurance plan’s provider network serve a given hospital.
The measure would apply to anesthesiologists, pathologists, radiologists and emergency room doctors, typically specialists responsible for the most incidents of surprise billing, the extra hospital charges that result from procedures performed by out-of-network specialists.
The legislation would strike a blow for transparency in the delivery of health-care services, said Rep. Mark Newton, R-Augusta, the committee’s chairman and the bill’s chief sponsor.
“If I want to have elective surgery … I don’t know if the anesthesiologist at my hospital is in my network,” he said. “I have no way to find out.”
Under the House bill, when an insurance company advertises a hospital as in its coverage network, the insurer would be required to disclose that hospital’s “surprise bill rating.” If the hospital’s rating is less than four, the insurer would have to disclose which of the four types of specialties are not in its network.
Kathleen Polvino, legal counsel for the Tifton-based Georgia Alliance of Community Hospitals, said the organization supports greater transparency in hospital billing. But she said the proposed rating system could cause confusion among patients, who might interpret a rating of less than four as a negative mark on a hospital.
“Patients might not know what it means,” she said. “We don’t want it to look like a hospital has failed.”
Newton responded that the proposed rating is meant to apply to insurance plans rather than hospitals.
“It will bring a spotlight of transparency on health plans,” he said.
Rep. Spencer Frye, D-Athens, the only committee member to vote against the bill, said he doesn’t believe it goes far enough.
“If we’re going to tackle this, we should be reining in these out-of-control insurance companies,” he said.
A Senate bill on surprise billing, in fact, would go further than the House measure. The legislation, sponsored by Sen. Chuck Hufstetler, R-Rome, would essentially prohibit the practice. Disputes between insurance companies and medical providers would be subject to arbitration conducted by the state Office of Insurance.
The Senate bill is pending before the Senate Insurance and Labor Committee. The House legislation needs only to clear the House Rules Committee, the chamber’s traffic cop for bills, before heading to the House floor.