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Opinion: California bill would put an end to surprise hospital billing

June 11, 2019, San Francisco, CA — Billing is often the last thing on a patient’s mind when being rushed to an emergency room, yet the billing practices of many hospitals and insurers suggest it should be at the top.

In April, Zuckerberg San Francisco General Hospital announced it was reviewing its internal billing tactics to put an end to hospital policies that leave patients with outstanding bills when their insurance refuses to pay for the entire treatment. The practice, also known as surprise or balance billing, often results in unexpected costs for consumers that can cause significant financial strain.

Surprise bills hit consumers when they are most vulnerable and leave them in the middle of disputes that are clearly between a hospital and insurer. Take Nina Dang, for example, who was hit with a surprise bill of $24,074.50 from Zuckerberg Hospital after her insurer only agreed to cover a fraction of her emergency room bill. Consumers want more clarity and predictability in health care, and they deserve to be protected from practices like surprise billing.

Recent Ipsos-Consumers for Quality Care (CQC) research shows that consumers, regardless of their income level, age, gender, race, or political identification, are almost universally worried about the cost of health care. Ninety-one percent of Americans are concerned about receiving surprise bills from hospitals; 65 percent say it is difficult to understand the cost of care at a hospital, including finding out how much a hospital charges for a specific type of care; and 60 percent support capping the amount hospitals can mark up the price of medicine.

Clearly, our current health care system is not working for consumers, leaving patients with confusing bills and little explanation as to why costs just keep going up. In an attempt to address this problem. Assemblyman David Chiu, D-San Francisco, and state Sen. Scott Wiener, D-San Francisco, introduced AB 1611 in an effort to protect consumers from surprise medical bills by limiting what a hospital can charge a patient, even if a hospital was out-of-network.

Putting an end to surprise billing is an important step in the right direction, but there is more that can be done to ease the financial and emotional stress consumers face from rising premiums and unexpected out-of-pocket costs. The pivotal finding in the Ipsos-CQC survey is that Americans ultimately want more predictability in what they are asked to pay for health-care services. They want their hard-earned dollars to go farther for them and they may even be willing to pay more upfront for better value and quality of care.

Based on those findings, CQC developed our Negotiator’s Guide, designed to give lawmakers a clearer understanding of what consumers want them to tackle when it comes to health care. This includes not only surprise bills, but also insurance costs like premiums, co-pays and deductibles, transparency in hospital charges, out-of-pocket costs for prescription drugs and routine visits, and more. A recent investigation of four major California hospitals looked at their chargemasters, which shows a hospital’s list prices, and found massive fluctuations in the costs of basic procedures. It’s simply unacceptable that consumers have no idea what they are going to be charged for treatment.

As health care advocates committed to giving consumers a voice in the health care debate, CQC strongly supports solutions that put consumers first. We applaud the Legislature for its actions on surprise billing and urge policymakers to make a positive difference in the lives of Californians by continuing to listen to the changes they want to see when it comes to health care.

Source: The Mercury News

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