Accident victims got some unexpected good news yesterday. A sweeping new law that will prevent most surprise medical bills was approved by Congress as part of pandemic-related legislation. The bill now moves to the President for approval. Bravo!
This has been a serious problem for many years. One of the biggest problems injured victims face comes weeks or even months later when they open their mail and find enormous surprise medical bills. This often happens because they have been treated by a hospital or doctor outside of their health insurance network so their company paid little, if any, money.
Of course, rarely. if ever. do people in emergency situations like car wrecks know in advance which providers will be paid.
This has resulted in an abusive practice called balance billing.
Further, victims have no idea that the hospital can charge any amount of money it wants to. We often see hospital bills exceeding ten thousand dollars due to treatment by multiple physicians and extensive diagnostic testing, not to mention huge costs for surgeries.
On the other hand, if the bills are in-network, there is no balance due, other that the co-pay and deductible.
Further adding to the financial stress, someone often has a health insurance plan but it claims that it is secondary and refuses to pay. In other casers, it eventually pays after a long delay, but then demands to be repaid in a process called subrogation.
To make matters worse, the at-fault driver’s liability company has no legal duty to pay the plaintiff’s medical bills up front, so it doesn’t pay until it knows all of the damages the injured victim has suffered and how much money they are demanding for compensation.
Surprise medical bills are a huge problem, especially in Texas where they are generated at two times the national average.
The new law will help hundreds of thousands of Americans every year.
Unfortunately, it does not take effect until January 1, 2022.
So after the surprise car crash and surprise medical treatment, the surprise medical bills will surprisingly be allowed to continue for a long time.
The bills for out-of-network services will now be based on what would be charged if the facility or professional were in-network. There will be process to resolve disputed claims.
Further, patients must be given estimates of the charges by out-of-network providers 72 hours in advance and be allowed to refuse to receive that care. But that places the injured person in a bind if he wants to use a certain surgeon or specialist.
Another surprise: ground ambulances, which can have the highest billing rates for any out-of-network facility, are exempt from the new guidelines. Rides to the hospital can easily cost $1,500.00. At least air ambulances will be governed by the new law and since their bills can exceed $50,o00.00, this is more welcome news.
Everyone, including health insurance company officials, hospitals, doctors, attorneys, and the U.S. Congress, have known for many years that surprise medical bills were abusive. But they are mailed out almost 90% of the time in some Texas cities.
This has resulted in endless collection notices, lawsuits, bankruptcies, and financial hardship. Yet it took years for the two political parties to reach this compromise.
Texas surprisingly adopted one of the strongest anti-surprise medical bills laws in the country last year. SB 1242 created an arbitration process that forced the parties to resolve their disputes. However, it had a glaring exception which allowed the highly-priced out-of-network providers to force patients to agree to their bills.
Our state has had a medical dispute process for over ten years. However, it has been so popular that the system has been overwhelmed: Medical bills medication requests stun Texas officials
We know how horrible being in a car or truck collision is, and the last thing you need is to have to do is pay outrageous medical bills. A personal injury lawyer will attempt to cut down your medical expenses and liens held by hospitals, Medicare, Medicaid, and other entities.
Here is more information on this important topic: Best ways to reduce huge medical bills
Please contact us if you have any questions.