Austin: I believe Hoosiers deserve better than this
INDIANAPOLIS – State Rep. Terri Austin (D-Anderson) released a statement on the House Enrolled Act 1004, which now awaits the Governor’s signature. The act puts significant new regulatory requirements on health care professionals including everyone from acupuncturists, chiropractors, dental hygienists, physicians, nurses, midwives, pharmacists, physical therapists and anyone else who comes under the Professional Licensing Agency.
As a result of this legislation, these professionals will be required to provide a patient or client with a written estimate of the cost of their services five days before the service is scheduled, beginning July 1, 2021. It also gives insurance companies the sole authority to determine what they will pay to out-of-network health care professionals. Insurance companies will have the authority to decide who is in the insurance plan’s network.
“This tips the scale in favor of insurance companies and is not in the best interest of consumers, said Austin. “It’s more paperwork for already overworked health care professionals and puts patients in the middle.
“It was purported to be a solution to the problem of ‘surprise’ or ‘balance billing’ – the bill a patient or client receives that is over and above what the insurance company decides they are willing to pay. But it's not.
“It is estimated that one in five emergency room visits result in surprise billing. Republicans will say they’ve made great strides this session to help prevent surprise billing, but the truth is, the legislation they pushed would help less than 20 percent of Hoosiers.
I, along with my fellow House Democrats, offered up alternatives that would have made a substantial difference for those who are struggling to cover their medical and insurance bills, like putting harsher regulations on pharmacy benefit managers and allowing the importation of drugs from Canada. By remaining stagnant on policies and refusing to make any significant changes this year, we are only prolonging the suffering of Hoosiers. I believe Hoosiers deserve better than this.”
State protections to surprise billing are limited. The federal law known as the Employee Retirement Income Security Act (ERISA) pre-empts state regulation. This includes health plan groups that are self-funded, faith-based insurance plans, and state employee plans. It also won’t apply to individuals covered by Medicaid or Medicare. This legislation will only affect about 17 percent of Hoosiers who have health insurance. It will not apply to emergency medical services – where a large majority of surprise billing occurs.