WSHA Member Testifies Regarding Emergency Services Balance Billing

January 28, 2016

On January 20, House Bill 2447 Emergency Balance Billing was heard by the House Health Care & Wellness Committee. The bill, requested by the Office of the Insurance Commissioner, is intended to protect patients from unexpected charges in cases where they receive emergency care at a hospital that is contracted with their health insurer, but not all physicians providing professional services are contracted with that plan.

Under the legislative proposal, patients could not be balance billed. Payment differences between the health plan and the provider would need to be resolved through a mediation process. The Washington State Medical Association, the Washington Chapter of the American College of Emergency Physicians, and health plans opposed the bill. John Gallagher, CEO of Sunnyside Community Hospital, testified from the hospital perspective in opposition to the bill, citing concerns that the bill would undermine existing contractual agreements between plans and providers, and could increase out-of-network services. Since hospitals are responsible for ensuring access to emergency services in their communities, this could result in additional cost to hospitals and potential loss of access to emergency services. (Andrew Busz)

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