Bills Would Require Hospitals to Pay Balances Billed to Patients

Posted on June 08, 2018

On June 7, the Senate Insurance Committee reported out House Bills 5217-5219, the bill package to curtail the use of air ambulances, primarily rotary aircraft, for nonemergency patients by requiring hospitals to pay any amount that remains after a health benefit plan pays its portion of the air ambulance bill.

As it did in the House, the MHA is opposing the bills in the Senate. Hospitals are aware of the problems that large balance bills cause for patients and their families. However, forcing hospitals and healthcare systems to pay the balance bill shifts the problem, rather than resolving it.

The federal Airline Deregulation Act (ADA) does not allow states to regulate air travel, air traffic and aircraft operators. The ADA pre-empts state-level regulation, so the state Legislature cannot directly regulate the air ambulance providers. Therefore, this package of bills forces the balance bill responsibility onto hospitals.

The MHA also raised concerns with drafting errors and excessive administrative burden imposed by the legislation. HB 5217 refers to a hospital requiring that a patient be transported in a specific way. Under the Michigan Public Health Code, a hospital is defined as a facility, not as a person capable of making decisions. Clinical decisions about patient care are made by physicians and other qualified, licensed clinicians. Despite several efforts to change the legislation to reflect this, the bill still references hospital decision-making.

The requirement to provide notice to the patient of the risk of receiving a bill for the balance of an out-of-network air ambulance provider is lengthy. It also requires detailed information about a patient’s health benefit plan, which will require a hospital administrative department to keep or track extensive information about healthcare benefits. These notice provisions are burdensome, add more cost to care delivery, and are likely to create anxiety for the patient about both their immediate safety and a later out-of-pocket expense. Requiring this conversation at the bedside during critical moments of care is not a solution to balance billing.

House Bills 5217-5219 are pending on the Senate calendar. Members are urged to call their state senator as soon as possible to express opposition to these bills and ask that he or she vote no if these bills come up for a vote this year. For more information, contact Laura Appel at the MHA.

Tags: advocacy, air ambulance, HB 5217-5219

Posted in: Issues in Healthcare

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