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Today, in a big win for Oregon consumers, the state House of Representatives voted to concur with Senate amendments and pass House Bill 2339, an urgently needed measure to protect Oregon consumers from large surprise medical bills. The bill now heads to the desk of Gov. Kate Brown, who is expected to sign it.
Consumers receive surprise medical bills in a variety of situations, but one far-too-common scenario occurs when patients receive treatment from a physician or other health care provider who does not participate in their health plan—often without the patient’s knowledge or consent—even though the patient sought care at an in-network facility. This leads to situations where patients who have done all that can reasonably be expected to access in-network services are stuck with surprise balance bills, which can sometimes be extraordinarily large.
Today, even the most savvy patients may be unable to avoid receiving a balance bill.
One Oregon consumer informs us that he checked well in advance of a scheduled surgery to ensure that all providers involved would be in his health plan’s network and was assured that he was protected, but on the day of the surgery, the in-network anesthesiologist called in sick and was replaced by someone who did not participate in the network, leading to a large balance bill. This simply should not happen.
We believe that consumers who do everything that can reasonably be expected of them should not be left on the hook for inadvertent and often unavoidable out-of-network charges. Consumers should be held harmless in these situations and should not be required to pay more than the in-network rate. HB 2339 will provide that necessary protection for Oregon consumers.
Today, without these protections, Oregonians who do everything right often have no recourse when they receive a giant bill they could do nothing to avoid. This status quo is unjust and unacceptable.
HB 2339 will put in place a permanent ban on billing consumers for more than the in-network rate when they unintentionally receive care from out-of-network providers at in-network facilities, starting in March of next year. It will also create a process to ensure that health care providers receive a reasonable reimbursement in these situations. OSPIRG is committed to participating in this process to ensure that there are no unintended adverse consequences for consumers--but regardless of the resolution of the reimbursement rate issue, consumers will be protected from surprise out-of-network medical bills.
OSPIRG applauds Oregon lawmakers for taking action , and Oregon's insurance regulators at the state Department of Consumer and Business Services for their hard work advancing this important legislation. Today's vote will make a big difference for Oregon consumers.
OSPIRG is a non-profit, non-partisan statewide consumer organization. Please visit us at www.ospirg.org
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