San Antonio Express-News: End Surprise Billing Act needed

Lloyd Doggett: Even with good insurance, out-of-network bills can bring out-of-control costs.

Re: "Billings for visits to ER stun patients; Docs often out of network," front page, Nov. 24:

Health insurance enrollment season is now through December 15. EnrollSA (www.enrollsa.com) offers free counseling on the best plan for you. But even with good insurance, out-of-network bills can bring out-of-control costs. Insurers separate providers between those "in" and "out" of their network.

Admission to an in-network hospital and requesting covered providers is no guarantee against getting socked with a shockingly high bill from a provider outside your insurance network. Medical expenses are high enough; imagine being surprised by a $10,000 bill after surgery when you thought you were fully covered. Patients, and their pocketbooks, are innocently caught in the middle of billing differences between insurers and providers.

That is why I introduced the End Surprise Billing Act, one of many health care improvements we need, which would protect patients from these out-of-network bombshell bills. My legislation requires advance notification regarding any out-of-network providers for which you could be billed for an elective procedure, along with an estimate of your out-of-pocket costs.

In an emergency, such as a car crash or when otherwise unable to consent to higher out-of-network rates, you would be protected from paying more than you would pay an in-network provider. This legislation would have protected the Pettit family, on whom this newspaper reported, and many other consumers from being abused by surprise bills. Unfortunately, special interests are blocking action on this legislation in Congress.

Surprise billing is a complex problem, but my legislation could help protect patients from suffering financial wounds as their bodies heal.

U.S. Rep Lloyd Doggett, a member of the Subcommittee on Human Resources, represents District 35.