Feb 28, 2019 - Health

Georgia's answer to surprise medical bills

In this image, three doctors stand in green scrubs in a hallway. One is holding a clipboard.

Photo: Getty Images

Georgia legislators are advancing a bill that aims to prevent patients from getting surprise medical bills. But that proposal could drive up costs across the board.

Details: The most recent version of the bill says that if patients unexpectedly receive "unanticipated ... out-of-network services," health insurers must pay doctors their full pre-insurance charges, or a metric that averages the highest percentiles of local charges — whichever is less.

  • Insurers would also have to pay out-of-network providers their full charges for ER patients, if the patient isn't quickly transferred to an in-network facility.

The catch: These rates would be very high. If doctors know they will get paid their full charges, or something very close to them, why would they accept lower rates by agreeing to be part of insurers' networks?

BTW: The state senator who is sponsoring the bill, Republican Chuck Hufstetler, is an anesthetist. Hufstetler and his office did not respond to questions.

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