Members of the Tennessee State Senate this week unanimously passed legislation that ends the practice of surprise or unexpected medical billing in Tennessee, also called balanced billing.
Surprise Medical Billing happens when a patient receives out-of-network care without his or her knowledge – either in an emergency or during a visit to an in-network facility. Weeks later, insurance companies send bills demanding patients pay money for services they assumed insurance would cover.
“Balanced billing occurs when providers bill a patient for the difference between the amount they charge and the amount the patient’s insurance covers,” according to the Tennessee Senate Republican Caucus’ weekly newsletter.
“The amount that insurers pay providers is almost always less than the providers’ ‘retail price.’ Some providers will bill the patient for the difference or balance, thus it’s called balanced billing.”
Senator Bo Watson (R-Hixson) sponsored the bill, SB 1. Watson said it ensures patients are not held responsible for balanced bills. Consumers will no longer get balanced bills when they seek emergency care or when they receive non-emergency care in an in-network hospital but are unknowingly treated by an out-of-network physician or laboratory, the senator said.
Under the bill, patients will pay only the deductibles and co-payment amounts that they would pay under the in-network terms of their insurance plans. The bill also creates an independent dispute resolution process between insurers and providers.
Representative Robin Smith (R-Hixson) is sponsoring companion legislation in the state house, HB 0002, according to the Tennessee General Assembly’s website.
The bill mirrors the federal “No Surprises Act,” which took effect earlier this year. The legislation, which passed in December 2020, attempts to end “surprise billing” from healthcare providers to protect patients from unexpected charges.
Specifically, the law requires providers to supply their patients with a “good faith estimate” when individuals do not have insurance or will pay for the treatment themselves.
U.S. Representative Mark Green (R-TN-07) said last month that the implementation of the new regulations have caused uneasiness and confusion for some healthcare providers.
Chris Butler is an investigative journalist at The Tennessee Star and The Georgia Star News. Follow Chris on Facebook, Twitter, Parler, and GETTR. Email tips to [email protected].
