Lawmakers consider medical billing protection for patients

The legislation was not included in the House budget

BOSTON (WWLP) – When you go to the hospital and get a procedure done, you may not be concerned if you have health insurance. But you could get hit with a big bill if you go out-of-network.

State lawmakers are considering legislation to protect you from out of your control medical costs.

“The unknown of a month after your procedure getting a bill in the mail and all of a sudden you owe $500, $1,000, multiple-thousands of dollars,” said State Senator Jim Welch, (D) West Springfield. “Well, part of the procedure was out of network.”

The Senate adopted Welch’s amendment to provide out-of-network billing protections for patients.

If the amendment makes it onto the final budget for next year, it would set billing and reimbursement rules to limit how much health care providers can charge you for a medical services if they don’t have a contract with your insurance company.

Patients often have to pay a larger percentage of the cost going out of network. The senator hopes the amendment will create more transparency around prices you have to pay for medical services and protect patients from financial hardships.

Doctors and health care providers have concerns that the amendment could cause difficulties for emergency rooms.

“The bill strikes the right balance. I think it takes into account the very legitimate needs that hospitals have to provide quick care,” said State Senator Eric Lesser, (D) Longmeadow. “At the same time, we need to make sure that people are protected from really outrageous price spikes that they have no control over.”

The legislation was not included in the House budget so it will need to pass the conference committee to be considered in the final budget.