To the Editor:
In commenting on the Feb. 14, 2017, article “Proposal to End ‘Surprise’ Billing Tied Up over Payment Formula,” we at FAIR Health first acknowledge and applaud the Georgia Legislature’s serious efforts to protect consumers from balance billing for emergency and surprise bills. But we also wish to clarify the role that FAIR Health and our data play in supporting such initiatives in Georgia and other states. Far from setting an “extremely high” benchmark for reimbursing providers, as one party in the debate was quoted as saying, FAIR Health does not offer or recommend any particular amount as a ...
A Georgia Senate panel Thursday passed legislation to halt ‘’surprise’’ medical billing – but not without a last-minute amendment that changed the contentious payment formula.
The Health and Human Services Committee approved Senate Bill 8, which will address those situations in which patients get unexpected bills from providers who are not in their network, even though the hospital is a network facility.
Consumers who have procedures or visit ERs at hospitals in their networks often think they have accounted for all the costs, only to get an additional bill for hundreds or even thousands of dollars from a non-network doctor.
These bills can ...
Humana’s planned pullout from Georgia’s insurance exchange at the end of 2017 would subtract yet another health insurer from the state’s marketplace.
The company, based in Louisville, Ky., is one of just five insurers offering plans this year in the Georgia exchange, which was created by the Affordable Care Act. UnitedHealthcare and Aetna were two heavyweights that bowed out of Georgia’s and other exchanges in 2017.
The Humana announcement Tuesday that it would pull out of the 11 state exchanges where it operates was followed Wednesday by the Trump administration announcing a proposed set of rule changes to boost the stability of the exchanges for 2018.
A Senate bill that aims to prevent ‘’surprise’’ medical billing remains stalled.
The major snag is a lack of agreement on a formula to determine reimbursement rates for doctors, said Sen. Renee Unterman, the bill’s sponsor, at a legislative hearing Tuesday. Unterman, a Republican from Buford, is also a nurse and has been concerned about the problem for a long time.
Surprise medical bills can come from ER doctors, anesthesiologists, radiologists, pathologists and others who are not in a patient’s insurance network — even though the hospital where they work is in the network.
Consumers who have procedures or visit ERs at facilities ...