Georgia measure would curb “surprise” ER bills

By Doug Richards, WXIA

ATLANTA — There appears to be a pitched battle brewing between Georgia’s emergency room doctors and insurance companies. The battle is over a bill in the state Senate designed to protect patients from unexpected bills from emergency room treatment.

By its very nature, a visit to an emergency room tends to be sudden.  Patients are seeking quick medical care. The cost tends to be back-of-mind.

“It was for some respiratory distress,” said Dan Harrison, recalling his visit last spring to a metro Atlanta emergency room with his six year old daughter.  The hospital, he says, was in his insurance network.

“It was like a $50 co-pay. And then right about the same time, I got a bill for physician services,” Harrison said.

It turned out the physician was not in the same insurance network as the hospital.  Harrison says he was blindsided by a bill of $780.  “I’m not sure that anyone should expect to say (while with doctors in an emergency room), are you in network? Or are you contracted? I mean that just doesn’t happen in an emergency room situation,” Harrison said.

To end “surprise bills,” a Senate proposal would forbid ER doctors from billing above the amount that they’d bill if they were in the hospital’s insurance network.   The measure would also provide for dispute resolution.

But the proposal could drain hospitals of its ER doctors, says retired emergency physician Chip Pettigrew.

“If the bill in its present form were to be enacted,” Pettigrew said, “we would totally be at the mercy of the insurance companies.”

Federal law requires emergency room doctors to treat patients regardless of their ability to pay.  Doctors say it’s a law exploited by insurance companies, which negotiate how much they’re willing to pay ER doctors.

“Usually the insurance companies will not negotiate fairly with us because they know we have to see the patient anyway,” Pettigrew said.  “And then they just pay us whatever they want.”

A Senate committee will hold a hearing on the bill Tuesday.

Copyright © 2017 WXIA

Source: WXIA