EHOUSE COMMITTEE ON CORPORATIONS 20 1 6 WITNESS SHEET Bill 2016 - 8004 DATE: 4/12/2016 SPONSOR: Representative Craven SUBJECT: Provides for a dispute resolution process for emergencv services and surprise bills for medical services performed bv nonparticipatinar (out-of- network) health care providers 0 ALL WRITTEN TESTIMONY MUST BE HANDED TO COMMITTEE CLERK FOR DISTRIBUTION PRIOR TO START OF MEETING. 0 CONTACT INFO REQUESTED Represent CONTACT INFO PRO CON Wm? rm ?mac i ?Pr .8 C??nffau (pram: art-rig hL'er?fi- to!) (em: ?lm/mu. ?lm/1mm Kl Qua/1977!? uglier ASh/J-cuk/ i0on 6/06 S/ue ?If gwaaf/UAZC Vb; gym? Balm 24 DMS ?11,ng . - arms or THE HEALTH INSURANCE COMMISSIONER STATE OF April 12, 2016 The Honorable Brian Patrick Kennedy Chair, House Committee on Corporations State House Providence, RI 02903 Re: 8004 An Act Related to Insurance Surprise Bills for Medical Services Dear Chairman Kennedy: The proposed legislation provides for a dispute resolution process when there is a dispute over a bill for services or surprise billing. The Of?ce of the Health Insurance Commissioner (OHIC) would be responsible for establishing and regulating the dispute resolution process. OHIC strongly agrees that the issue of surprise billing needs to be addressed and that it is necessary for the State to work towards a solution to protect patients. R.I. Gen. Laws 23-17.13 (The Health Plan Act) focuses on ensuring quality of care, access to care and continuity of care. Though this section of the laws does not fall under OHIC?sjurisdiction, we do believe that this is an area of the law we can start with to work towards regulating surprise billing. The proposed legislation adds 27-81-4 Billing and Reimbursement. The preposed language in this section is duplicative of RI Gen. Law 27-18-76 and Federal law 42 USC 300gg-l9a, which address the fact that health insurance carriers must provide coverage for emergency services without the need for a prior authorization determination, even if the emergency services are provided on an out-of-network basis. In addition, both the federal and RI laws state that co-payments for such emergency services should be equal whether a person seeks services in-network or out?of?network. The proposed legislation provides a process for the patient to dispute a bill for a service from an out of network provider. However, we need to do much more than just provide a dispute process we need to go much further in managing this problem. OHIC is very interested in understanding how the dispute resolution process has worked in other states, speci?cally New York. In addition, we would like more information on which areas of practice are most affected by surprise billing g. providing anesthesia). OHIC would be interested in working with other state agencies, sponsors of the proposed legislation and other stakeholders to work towards a solution for surprise billing. Protecting Consumers - Ensuring Solvency - Engaging Providers - Improving the System 151 1 Pontiac Avenue a Building #69, First Floor - Cranston. RI 02920 - 401.462.9517 - Page 2 of 2 Thank you for your consideration. Sincerely, .r f, . .. Kathleen C. Hittner, MD. Health Insurance Commissioner Cc: Honorable Robert E. Craven, Sr. Honorable Members of the House Committee on Corporations Richard Raspallo Protecting Consumers - Ensuring Solvency - Engaging Providers 0 Improving the System 15] 1 Pontiac Avenue 0 Building #69, First Floor - Cranston. RI 02920 - 401.462.9517 -