PALLONE OFFERS A FIX FOR SURPRISE MEDICAL EXPENSES

“You go into the emergency room, that is not the time to ask as you’re laying there and brought in on an ambulance whether the doctor is in your network or not. And what are you going to do if they say no,” said Assembly Speaker Craig Coughlin (D-Middlesex).

Coughlin was a sponsor of the New Jersey bill and said it took 10 years to get it through the Legislature. Now the federal bill Pallone is pushing has even the support of President Donald Trump.

“They weren’t told by the doctor, they weren’t told by the hospitals in the areas they were going to, and they get what we call a surprise bill — not a pleasant surprise, a very unpleasant surprise, so this must end. We’re going to hold insurance companies and hospitals totally accountable,” Trump said in May.

Advocates on board

The New Jersey law only covers about 30 percent of the state. Large unions and large corporations that self-fund their healthcare are exempt. The federal law ropes them into the new set of rules. Healthcare advocates are enthused.

“It’s great to have chairman Pallone and members of Congress really behind this effort, and we think it will be a real game changer for healthcare consumers across the country,” said Maura Collinsgru, healthcare program director at New Jersey Citizen Action.

Doctors groups are lukewarm about the reforms. The president of the Medical Society of New Jersey, Dr. Marc Levine says: “We have concerns with the legislation designed to address surprise medical bills resulting from inadequate insurance coverage. We are pleased the legislation was amended to include a dispute resolution mechanism but remain concerned the level of payments are based on insurance company unilateral decisions.”

Balance that against stories like one from a nurse at a New Jersey hospital who had a medical crisis in her own ER.

“She was unconscious by the time she was shipped out. She had no say on where she went. She couldn’t speak. She went to an out-of-network hospital and was hit with a half-million dollars in medical bills,” said Bridget Devane, public policy director with Health Professionals & Allied Employees.

The No Surprise Act has passed committees in the House and the Senate with bipartisan backing. Pallone said he expects the president will sign it sometime this fall.

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