Health Care

‘Surprise’ medical bill protection clears Senate

March 10, 2021

Ray Carter

Legislation that could prevent Oklahomans from receiving unanticipated and wildly inflated medical bills has received approval from the Oklahoma Senate.

Senate Bill 548, by Sen. Julie Daniels, would prevent medical providers from turning a customer bill over to a collection agency if the provider did not first provide a “good faith” estimate of the total cost in advance of treatment.

“This is a health-care consumer protection bill,” said Daniels, R-Bartlesville.

The legislation requires the estimate to reveal the “total cost of all healthcare services,” including all services performed by a contractor, affiliate or any other third party, including out-of-network providers.

SB 548 would require medical providers to produce the estimate “separately from all other forms, information and paperwork” and provide it in “a readable font, plain language” that must be “prominently and conspicuously displayed on the first page of the document in which it is contained.”

In cases involving emergency care when a cost estimate cannot be provided prior to treatment, the legislation would limit the provider bill to no more than 165 percent of the Medicare rate and no more than “the enrollee’s health benefit plan’s in-network rate for the emergency services rendered.”

Should a medical provider fail to produce an advance good-faith estimate of treatment cost, the lack of an estimate would be “grounds for dismissal of any collection suit or garnishment proceeding and may be asserted as an affirmative defense to any such action.”

Sen. Michael Brooks, D-Oklahoma City, asked if there was any concern that the legislation “may cause medical providers to inflate their initial estimates out of concern that otherwise they may not get paid?”

Daniels noted the legal definition of a “good faith” estimate should ban such abuses.

Daniels indicated the bill is expected to be revised as it continues through the legislative process. When asked what changes she anticipates, Daniels said the bill is already “a good product” but may be refined.

“My goal is to make sure that we do not water it down to the point that it’s really not accomplishing its goal,” Daniels said.

SB 548 passed the Oklahoma Senate on a 38-9 vote that broke along party lines with Republicans in support.