State public health officials are touting a new law set to go into effect this year aimed at preventing “surprise” billing by health care providers.
Gov. Charlie Baker signed the law in 2021 requiring that health care providers tell patients how much they will pay for planned hospital stays, medical procedures, healthcare services and referrals — based on their individual health plans.
The new requirements, which were originally set to go into effect Jan. 1, were delayed amid concerns that they conflict with pending new federal protections.
The Baker administration has set a new date of July 31 to implement the law, and wants to make patients and providers aware of their rights and obligations.
In a letter to providers, the state Department of Public Health explains that health care practitioners covered by the law will be required to notify prospective patients if they participate in their health plan when scheduling an appointment, procedure or non-emergency medical service.
“This notice must be given at the time of an admission, procedure or service scheduled for a condition it is not an emergency medical condition or upon request by the patient,” the agency wrote.
So-called ‘surprise’ medical bills occur when insured patients inadvertently receive care from out-of-network hospitals, doctors or other providers they didn’t choose. Some patients have reported getting hit with hospital bills for hundreds of thousands of dollars in out-of-pocket expenses, not covered by insurance.
A recent study by the Kaiser Family Foundation found that surprise billing happens in about one in every five hospital visits.
“We are pleased that action has been taken at both at the federal and state levels to address surprise out-of-network billing, which can burden consumers with high bills and medical debt they had no way of avoiding,” said Alyssa Vangeli, co-director of policy and government relations at Health Care For All, a nonprofit advocacy group.
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