Relief from unexpected medical bills

Ohio consumers could see the end of those nasty surprise medical bills under the terms of a bill moving through the General Assembly.

This is a good plan, particularly as many Ohioans will face medical expenses related to the coronavirus pandemic. Even before the coronavirus outbreak, the burden of unexpected, often hefty, medical bills was an issue that lawmakers needed to solve.

More and more consumers complain that they have received a bill for medical treatment that they had thought was covered by their insurance. In some cases, the bills amount to thousands of dollars that patients can’t afford.

In many instances, these bills stem from cases in which patients end up unwittingly going out of their approved insurance network.

While no federal legislation addresses the issue, states have taken on unexpected medical expenses with at least 28 of them passing laws to regulate surprise medical bills.

The Ohio House of Representatives has approved a new version of a bill aimed at curbing unexpected medical bills that is expected to get the support from Gov. Mike DeWine that a previous version lacked.

House Bill 388 calls for out-of-network providers to send bills to patients’ insurance companies.

After getting a bill from an out-of-network provider for one of their insured patients, the insurance companies can then negotiate by offering a different amount. The provider seeking payment can accept the insurance company’s offer or negotiate further. If the bargaining fails, the matter can be resolved with arbitration.

Governor DeWine vetoed a previous version of the plan, which was included in the two-year state budget. The governor said he had concerns it would be a hardship for health providers who might not get paid or that insurance companies would shift the expenses to other customers.

The new version, which spells out the negotiating process between providers and insurers, is expected to get more support from the governor and from insurance and health care companies.

What matters most, however, is whether the bill will put a stop to the sticker shock of medical bills for patients who weren’t expecting them. Ohio consumers have waited long enough for relief and the state Senate and Governor DeWine should embrace this compromise solution.

— Toledo Blade; Online: