Indiana hopes to end surprise medical billing

Politics

INDIANAPOLIS, Ind. — For most of 2019, Abby Rugenstein has been asked to pay for a medical bill she didn’t know was coming.

She said collections has called her every single day.

“If I’m going to be completely honest with you, I’ve kind of stopped dealing with it because we don’t have the money to pay it right now,” said Rugenstein.

In October of 2018, Rugenstein received a shot to help ease her back pain.

“I was put under a local anesthesia, I had it done at the hospital, and prior to this appointment coming up, I was checking with my insurance company, I was checking with the doctor because I didn’t want any surprises whatsoever,” said Rugenstein.

But she says she was surprised with a bill anyway.

“Late March comes, and I get a bill from the hospital saying I owed them $3,800, and I had a week to pay it,” said Rugenstein.

Had she known this before the procedure, she said she would have never done it.

“I would have researched other places or find other alternative methods for my back pain,” said Rugenstein. “I wouldn’t have spent $3,800 on a shot.”

She’s not the only victim of surprise billing. The Indiana Hospital Association said this is happening more often.

“I think when you see more insurance companies having disputes with independent physician groups, that is one of the drivers,” said Brian Tabor, president of the Indiana Hospital Association. “They can’t reach an agreement on fair negotiation.”

That’s why IHA is advocating for lawmakers to step in and take the patient out of the middle.

“We’re starting to see other states take action as well: New York, Texas, a few others have acted in this area,” said Tabor.

New York takes the patient out of the equation and allows the insurance company and the health provider to offer their own prices. Then, a neutral third party picks which one they feel is fair for the service.

Some fear doctors might get shorted in these deals, resulting in low-quality care.

“As long as you maintain free market negotiations between those independent doctors and the insurance companies, then I don’t think that would happen,” said Tabor. “We do have to be concerned, and we would oppose setting a government rate. I think that could impact those independent doctors.”

The way Indiana plans to solve surprise billing is unknown at this point.

Governor Eric Holcomb and state leadership have announced surprise billing as a priority for 2020.

It’s a little too late for people like Rugenstein, but she’s glad they’re looking to fix this.

“I would like to see a more upfront system so I’m not surprised six months later,” said Rugenstein.

We reached out to insurance companies and lobbyists regarding a potential surprise billing law but are yet to hear back.

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