CALLING FOR STORIES: SURPRISE MEDICAL BILLS
Health Access California
January 11, 2016
Have you been hit with a surprise medical bill? Did you follow your insurance company’s rules by picking a hospital, lab, or outpatient facility that is in your plan’s network to keep costs low? But then did you end up getting a huge surprise medical bill from specialists, labs, or others who are not in your plan’s network—providers you didn’t choose, may have never met, and had no control over?
Health Access, California’s health consumer advocacy coalition, is looking for stories of people dealing with surprise medical bills. Your story can help us pass AB 533 so you’re no longer on the hook for these outrageous and unfair medical bills!
Health Access will share consumer stories, always with permission, with legislators and the media to show how this problem affects consumers like you.
Click here to share your story:
https://www.surveymonkey.com/
Or, if you prefer to talk with a Health Access staff member about your situation or you are not sure if you received a surprise medical bill, please contact:
Muneera Gardezi: Phone: (310) 597-2083. Email: mgardezi@health-access.org
AB-533 Health care coverage: out-of-network coverage
Partial text of bill as amended on September 4, 2015
This bill would require a health care service plan contract or health insurance policy issued, amended, or renewed on or after January July 1, 2016, to provide that if an enrollee or insured obtains care receives covered services from a contracting health facility, as defined, at which, or as a result of which, the enrollee or insured receives covered services provided by a noncontracting individual health professional, as defined, the enrollee or insured is would be required to pay the noncontracting individual health professional only the same cost sharing required if the services were provided by a contracting individual health professional. The bill would prohibit an enrollee or insured from owing the noncontracting individual health professional at the contracting health facility more than the in-network cost sharing cost-sharing amount if the noncontracting individual health professional receives reimbursement for services provided to the enrollee or insured at a contracting health facility from the health care service plan or health insurer. However, the bill would make an exception from this prohibition if the enrollee or insured provides written consent that satisfies specified criteria. The bill would require a noncontracting individual health professional who collects more than the in-network cost-sharing amount from the enrollee or insured to refund any overpayment to the enrollee or insured, as specified, and would provide that interest on any amount overpaid by, and not refunded to, the enrollee or insured shall accrue at 15% per annum, as specified.